Surgical Treatment of Hip Abductor Tendon Tears

Davies, Joseph; Stiehl, James B.; Davies, Joseph A.; Geiger, Patrick

doi:10.2106/jbjs.l.00709

Cited by 107 publications

(133 citation statements)

References 28 publications

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“…Trans-osseous repair using nonabsorbable sutures to reattach the abductor mechanism to the greater trochanter seems to be the favoured option [3,4,[14][15][16]. Results of these procedures are unpredictable.…”

Section: Discussionmentioning

confidence: 99%

“…Four patients still walked with a limp and two patients had a positive Trendelenburg test. Davies et al [16] described 24 patients (22 women, two men) with a mean age of 67 years with trans-osseous sutures or suture anchor repair of the glutei. In their series they reported that all but one patient had improvement in hip pain and muscle strength at a minimum two-year follow-up.…”

Section: Discussionmentioning

confidence: 99%

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Surgical repair of hip abductors. A new technique using Graft Jacket® allograft acellular human dermal matrix

Rao

Kamal

Vafaye

et al. 2012

International Orthopaedics (SICOT)

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Purpose Avulsion of the abductors from the hip can be an infrequent but debilitating complication after total hip arthroplasty performed through a trans-gluteal approach. This can result in intractable pain, limp, Trendelenberg lurch and instability of the hip. There have been various methods described for repairing or reconstruction of this abductor muscle complex including direct trans-osseous repair, muscle transfers, muscle and tendon sling, bone tendon allograft reconstruction and endoscopic repair techniques. Methods In a prospective study at our institution we evaluated the results of a surgical technique in 12 patients using a transosseous repair of gluteus medius and minimus insertions augmented by a Graft Jacket® allograft acellular human dermal matrix (Graft Jacket®; Wright Medical Technology, Arlington, TN) over the anterior and anterolateral aspects of the greater trochanter. Diagnosis of hip abductor avulsions was made by evaluation of the history of presenting complaint, clinical examination and confirmed by ultrasound or MRI scans.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Surgical repair of hip abductors. A new technique using Graft Jacket® allograft acellular human dermal matrix

Rao

Kamal

Vafaye

et al. 2012

International Orthopaedics (SICOT)

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“…The evidence for outcomes of surgical repair of gluteal tendon tears is limited to case reports, which provide only weak evidence. Patients who have failed conservative rehabilitation, have significant abductor muscle weakness and have a muscle tear identified on MRI are generally reported to do well in the 1-to 2-year follow-up period following surgery [15,[81][82][83][84][85]. But, in the absence of a control group, it is unclear whether this is better than the natural course.…”

Section: Surgical Interventionsmentioning

confidence: 99%

Gluteal Tendinopathy: A Review of Mechanisms, Assessment and Management

Grimaldi¹,

et al. 2015

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Tendinopathy of the gluteus medius and gluteus minimus tendons is now recognized as a primary local source of lateral hip pain. The condition mostly occurs in mid-life both in athletes and in subjects who do not regularly exercise. Females are afflicted more than males. This condition interferes with sleep (side lying) and common weight-bearing tasks, which makes it a debilitating musculoskeletal condition with a significant impact. Mechanical loading drives the biological processes within a tendon and determines its structural form and load-bearing capacity. The combination of excessive compression and high tensile loads within tendons are thought to be most damaging. The available evidence suggests that joint position (particularly excessive hip adduction), together with muscle and bone elements, are key factors in gluteal tendinopathy. These factors provide a basis for a clinical reasoning process in the assessment and management of a patient presenting with localized lateral hip pain from gluteal tendinopathy. Currently, there is a lack of consensus as to which clinical examination tests provide best diagnostic utility. On the basis of the few diagnostic utility studies and the current understanding of the pathomechanics of gluteal tendinopathy, we propose that a battery of clinical tests utilizing a combination of provocative compressive and tensile loads is currently best practice in its assessment. Management of this condition commonly involves corticosteroid injection, exercise or shock wave therapy, with surgery reserved for recalcitrant cases. There is a dearth of evidence for any treatments, so the approach we recommend involves managing the load on the tendons through exercise and education on the underlying pathomechanics.

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“…10,11 Traditionally, this was performed through an open approach because this allowed visualization of the footprint, preparation of bone surfaces, and fixation of tendon to bone. [12][13][14] However, with advancements in endoscopic instruments and techniques, there has been a recent increase in the prevalence of endoscopic repairs. [15][16][17][18] The aim of this systematic review was to compare the outcomes of open versus endoscopic gluteal repairs and provide an algorithm regarding the indications and benefits for each approach.…”

mentioning

confidence: 99%

Outcomes of Open Versus Endoscopic Repair of Abductor Muscle Tears of the Hip: A Systematic Review

Chandrasekaran

Lodhia

Gui

et al. 2015

Arthroscopy: The Journal of Arthroscopic & Related Surgery

107

104

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Surgical Treatment of Hip Abductor Tendon Tears

Abstract: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Cited by 107 publications

References 28 publications

Surgical repair of hip abductors. A new technique using Graft Jacket® allograft acellular human dermal matrix

Surgical repair of hip abductors. A new technique using Graft Jacket® allograft acellular human dermal matrix

Gluteal Tendinopathy: A Review of Mechanisms, Assessment and Management

Outcomes of Open Versus Endoscopic Repair of Abductor Muscle Tears of the Hip: A Systematic Review

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