Surgical Technique: Gluteus Maximus and Tensor Fascia Lata Transfer for Primary Deficiency of the Abductors of the Hip

Whiteside, Leo A.

doi:10.1007/s11999-013-3161-x

Cited by 96 publications

(67 citation statements)

References 14 publications

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“…Surgical intervention is normally recommended for patients suffering from volumetric muscle loss that requires soft tissue reconstruction . The current clinical standard for treating volumetric defects is the replacement of lost tissue by muscle flaps . This involves the autologous transfer and engraftment of healthy, innervated, and vascularized muscle tissue either from the direct vicinity of the injured area or from a distant site of the body as a free flap.…”

Section: Clinical Options For Treatmentmentioning

confidence: 99%

“…[46][47][48] The current clinical standard for treating volumetric defects is the replacement of lost tissue by muscle flaps. 49 This involves the autologous transfer and engraftment of healthy, innervated, and vascularized muscle tissue either from the direct vicinity of the injured area or from a distant site of the body as a free flap. The biggest drawback of the muscle flap procedure is donor site morbidity that further prolongs patient recovery time.…”

Section: Surgical Treatmentmentioning

confidence: 99%

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Cell therapy to improve regeneration of skeletal muscle injuries

Qazi

Duda

Ort

et al. 2019

J cachexia sarcopenia muscle

110

128

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Diseases that jeopardize the musculoskeletal system and cause chronic impairment are prevalent throughout the Western world. In Germany alone, ~1.8 million patients suffer from these diseases annually, and medical expenses have been reported to reach 34.2bn Euros. Although musculoskeletal disorders are seldom fatal, they compromise quality of life and diminish functional capacity. For example, musculoskeletal disorders incur an annual loss of over 0.8 million workforce years to the German economy. Among these diseases, traumatic skeletal muscle injuries are especially problematic because they can occur owing to a variety of causes and are very challenging to treat. In contrast to chronic muscle diseases such as dystrophy, sarcopenia, or cachexia, traumatic muscle injuries inflict damage to localized muscle groups. Although minor muscle trauma heals without severe consequences, no reliable clinical strategy exists to prevent excessive fibrosis or fatty degeneration, both of which occur after severe traumatic injury and contribute to muscle degeneration and dysfunction. Of the many proposed strategies, cell‐based approaches have shown the most promising results in numerous pre‐clinical studies and have demonstrated success in the handful of clinical trials performed so far. A number of myogenic and non‐myogenic cell types benefit muscle healing, either by directly participating in new tissue formation or by stimulating the endogenous processes of muscle repair. These cell types operate via distinct modes of action, and they demonstrate varying levels of feasibility for muscle regeneration depending, to an extent, on the muscle injury model used. While in some models the injury naturally resolves over time, other models have been developed to recapitulate the peculiarities of real‐life injuries and therefore mimic the structural and functional impairment observed in humans. Existing limitations of cell therapy approaches include issues related to autologous harvesting, expansion and sorting protocols, optimal dosage, and viability after transplantation. Several clinical trials have been performed to treat skeletal muscle injuries using myogenic progenitor cells or multipotent stromal cells, with promising outcomes. Recent improvements in our understanding of cell behaviour and the mechanistic basis for their modes of action have led to a new paradigm in cell therapies where physical, chemical, and signalling cues presented through biomaterials can instruct cells and enhance their regenerative capacity. Altogether, these studies and experiences provide a positive outlook on future opportunities towards innovative cell‐based solutions for treating traumatic muscle injuries—a so far unmet clinical need.

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Section: Clinical Options For Treatmentmentioning

confidence: 99%

Section: Surgical Treatmentmentioning

confidence: 99%

Cell therapy to improve regeneration of skeletal muscle injuries

Qazi

Duda

Ort

et al. 2019

J cachexia sarcopenia muscle

110

128

View full text Add to dashboard Cite

show abstract

“…11 However, these procedures do not always restore adequate func-tion. 5,8,[12][13][14][15][16][17][18] MRI has been used to evaluate the extent of the muscle damage sustained in primary THR. 19 The muscle damage caused by revision THR has not yet been evaluated.…”

mentioning

confidence: 99%

Significant muscle damage after multiple revision total hip replacements through the direct lateral approach

Roth

Abdel

Wauer

et al. 2014

The Bone & Joint Journal

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Intact abductors of the hip play a crucial role in preventing limping and are known to be damaged through the direct lateral approach. The extent of trauma to the abductors after revision total hip replacement (THR) is unknown. The aim of this prospective study was to compare the pre- and post-operative status of the gluteus medius muscle after revision THR. We prospectively compared changes in the muscle and limping in 30 patients who were awaiting aseptic revision THR and 15 patients undergoing primary THR. The direct lateral approach as described by Hardinge was used for all patients. MRI scans of the gluteus medius and functional analyses were recorded pre-operatively and six months post-operatively. The overall mean fatty degeneration of the gluteus medius increased from 35.8% (1.1 to 98.8) pre-operatively to 41% (1.5 to 99.8) after multiple revision THRs (p = 0.03). There was a similar pattern after primary THR, but with considerably less muscle damage (p = 0.001), indicating progressive muscle damage. Despite an increased incidence of a positive Trendelenburg sign following revision surgery (p = 0.03) there was no relationship between the cumulative fatty degeneration in the gluteus medius and a positive Trendelenburg sign (p = 0.26). The changes associated with other surgical approaches to the hip warrant investigation.

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“…Preoperative assessment of abductor strength is essential. If the abductor mechanism has been significantly damaged, a dual mobility implant may be considered to improve implant stability or alternative soft tissue reconstructions may be considered including transfer of the gluteus maximus or Achilles tendon allograft [61,62]. Furthermore, although theoretically concerning in the setting of a recent acetabular reconstruction, a constrained acetabular liner may be considered if intraoperative stability of a THA cannot be achieved due to soft tissue destruction.…”

Section: Technical Considerationsmentioning

confidence: 99%

Conversion of a failed hip resurfacing arthroplasty to total hip arthroplasty: pearls and pitfalls

Haynes

Stambough

Barrack

et al. 2016

Curr Rev Musculoskelet Med

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Surface replacement arthroplasty (SRA) remains a viable alternative to total hip arthroplasty (THA) in appropriately selected, active adults with degenerative hip disease. However, orthopedic surgeons are facing a number of scenarios where revision of one or both components of an SRA is indicated. Indications for revision vary and impact the potential outcomes of conversion of a SRA to THA. While clinical outcomes are generally favorable, a growing body of data illustrates patients who undergo conversion of a SRA to THA to be at increased risk of requiring a repeat revision surgery and experiencing functional outcomes inferior to that of a primary THA. The results of patients undergoing conversion of a SRA to THA highlight the need for careful patient selection, thorough preoperative counseling, and technical precision when performing a SRA. Furthermore, a systematic approach to the failed SRA is necessary to ensure optimal clinical results.

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Surgical Technique: Gluteus Maximus and Tensor Fascia Lata Transfer for Primary Deficiency of the Abductors of the Hip

Cited by 96 publications

References 14 publications

Cell therapy to improve regeneration of skeletal muscle injuries

Cell therapy to improve regeneration of skeletal muscle injuries

Significant muscle damage after multiple revision total hip replacements through the direct lateral approach

Conversion of a failed hip resurfacing arthroplasty to total hip arthroplasty: pearls and pitfalls

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