Arthroscopic revision release of gluteal muscle contracture after failed primary open surgery

Zhang, Xintao; Jiang, Xiaocheng; He, Feilin; Liang, Zuru; You, Tian; Jin, Dadi; Zhang, Wentao

doi:10.1007/s00264-016-3354-5

Cited by 17 publications

(26 citation statements)

References 10 publications

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“…Prior studies in Uganda, as well as other higher resource countries, have highlighted the concern for injection injury related conditions [12–15]. In 2004, post-injection paralysis was seen in 10% of patients seen in a Kumi, Uganda Community Based Rehabilitation (CBR) Project and 8% of pediatric operations in Kumi Hospital (N. Penny, personal communication, June 13, 2017).…”

Section: Discussionmentioning

confidence: 99%

“…Of note, conditions caused by suspected iatrogenic injection injuries (GF, QF and PIP) account for over 30% of hospital clinic visits for musculoskeletal conditions and 40% of outreach visits for any medical complaint in this northeastern region of Uganda. Prior studies in Uganda, as well as other higher resource countries, have highlighted the concern for injection injury related conditions [12–15]. In 2004, post-injection paralysis was seen in 10% of patients seen in a Kumi, Uganda Community Based Rehabilitation (CBR) Project and 8% of pediatric operations in Kumi Hospital (N. Penny, personal communication, June 13, 2017).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Paediatric musculoskeletal disease in Kumi District, Uganda: a cross-sectional survey

Alves

Penny

Kobusingye

et al. 2018

International Orthopaedics (SICOT)

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While population-based estimates of disease burden and resource utilization are needed, this data offers insight into burden of musculoskeletal disease for this region of Sub-Saharan Africa. We estimate that 50% of the surgical conditions could be prevented with policy changes and education regarding injection practices and early care for traumatic injuries, clubfeet, and infection. This study highlights a need to increase capacity to care for specific musculoskeletal conditions, including gluteal fibrosis, post-injection paralysis, infection, and trauma in the paediatric population of Uganda.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Paediatric musculoskeletal disease in Kumi District, Uganda: a cross-sectional survey

Alves

Penny

Kobusingye

et al. 2018

International Orthopaedics (SICOT)

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“…The advantages of arthroscopic GMC release are that allows the surgeon to clearly identify scar tissue under the arthroscope and accurately release the contractile bands scattered between muscle bundles without cutting off normal muscle; it allows for simultaneous haemostasis, including that of minor bleeding points during release, which significantly reduces postoperative wound drainage and the probability of wound haematoma; and it requires a small incision, which meets the patients' aesthetic requirements, particularly those of young women. The disadvantages are that the procedure for severe GMC is difficult; it is difficult to effectively expose the gluteus minimus, piriformis, joint capsule and sciatic nerve; for contractures deeper than the gluteus medius, it is difficult to achieve extensive and thorough release while ensuring the safety of the sciatic nerve; for GMC cases with the same degree of contracture, the duration of arthroscopic surgery performed by beginners is longer than that of open surgery; and it has a relatively low efficiency for release and is unsuitable for the release of GMCs in large areas (22,23).…”

Section: Discussionmentioning

confidence: 99%

Comparison of the clinical effects of arthroscopic surgery vs. open surgery for gradeï¿½II gluteal muscle contracture in adults

Zhang

et al. 2018

Exp Ther Med

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The aim of the present study was to compare the clinical effects of arthroscopic surgery with open surgery for grade II gluteal muscle contracture (GMC) in adults and to discuss the indication and technique for arthroscopic GMC release. The clinical data of 113 adult patients with grade II GMC between 2011 and 2016 was retrospectively collected. Among these patients, 72 patients received open surgery and 41 received arthroscopic surgeryy. The 2 groups were compared in terms of surgical duration, incision size, blood loss, hospital stay, analgesic dose and ranking of postoperative functions and effects. Mean surgical duration was significantly greater in the arthroscopic surgery group (P<0.001). Mean incision size, blood loss, hospital stay and analgesic dose were significantly lower in the arthroscopic surgery group compared with the open surgery group (P<0.001). There was no significant difference observed regarding the ranking of functions and effects between the two groups. These results suggest that existing untreated patients with GMC having low-severity (grade II) contractures of limited area are suitable for arthroscopic surgery. The advantages of arthroscopic GMC release include limited surgical trauma, a small incision, low blood loss and fewer surgical complications.

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“…They are usually unable to bring both knees together when crouching and to cross the affected leg completely without any support [8]. Exercises and stretching of the shortened muscles do not produce notable improvement [2], while arthroscopic release of GF has shown remarkable improvement in symptoms and quality of life for the patients [9][10][11][12]. However, the technique and outcomes of arthroscopic release for moderate and severe GF in adults are rarely discussed in the previous reports.…”

Section: Introductionmentioning

confidence: 99%

Clinical results of arthroscopic tight fibrous band release for adult moderate-to-severe gluteal fibrosis using anterior and posterior portal: a retrospective analysis of 118 consecutive cases

Yang

Liu

et al. 2020

Preprint

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Background To evaluate the clinical outcomes of arthroscopic tight fibrous band release in the treatment of adult moderate-to-severe gluteal fibrosis using anterior and posterior portals during medium and long-term follow-ups. Methods The data of 138 patients (58 males, 80 females) aged between 18 and 42 years (mean, 28.6 years), presenting with bilateral moderate-to-severe gluteal fibrosis (GF) from October 2013 to August 2019, was retrospectively analyzed. All patients underwent arthroscopic tight fibrous band release using anterior and posterior portals with radiofrequency energy. Under arthroscopic guidance through the posterior portal, we debrided the fatty tissue overlying the contracted band of the gluteal muscle and excised the contracted bands using a radiofrequency device introduced through the anterior portal. The pre- and post-operative gluteal muscle contracture disability (GD) scale and the patient satisfaction rate were compared to evaluate the curative effect of the operation. Results The average operation time was 18 min (range, 10–30 min) and the average blood loss was 4 ml (range, 2–10 ml) for unilateral arthroscopic release. Two cases of post-operative minimal hematomas, 2 cases of bruising and 2 cases of local subcutaneous edema were observed as early complications and were cured by conservative treatment. After surgery, all incisions healed in stage I, and no other complications such as wound infection, nerve and blood vessel injury were detected. 118 patients were followed up for 6 to 72 months (mean, 36 months). No lateral instability of the hip was observed and all patients returned to normal gait. The degree of adduction of the hip joint in all these 118 patients was significantly improved relative to their pre-operative conditions. 115 patients (97.5%) were able to crouch with knees close to each other after surgery. 114 patients (96.6%) were able to cross the affected leg completely without any support. The GD scale was improved from 55.5 ± 10.6 before operation to 90.1 ± 5.2 at the last follow-up (p < 0.05). The patient satisfaction rate was 95.8%. Conclusion Arthroscopic tight fibrous band release using anterior and posterior portals is minimally invasive for adult moderate-to-severe gluteal fibrosis, with a high success rate, quick recovery after surgery and reliable medium- and long-term effect.

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Arthroscopic revision release of gluteal muscle contracture after failed primary open surgery

Abstract: The three-step arthroscopic release procedure is effective for failed primary open GMC surgeries as shown by improved post-operative function and patient satisfaction regardless of which primary procedure was performed.

Cited by 17 publications

References 10 publications

Paediatric musculoskeletal disease in Kumi District, Uganda: a cross-sectional survey

Paediatric musculoskeletal disease in Kumi District, Uganda: a cross-sectional survey

Comparison of the clinical effects of arthroscopic surgery vs. open surgery for gradeï¿½II gluteal muscle contracture in adults

Clinical results of arthroscopic tight fibrous band release for adult moderate-to-severe gluteal fibrosis using anterior and posterior portal: a retrospective analysis of 118 consecutive cases

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