ePoster #1108 - ISHA Annual Scientific Meeting 2016

Outcomes Of Gluteus Maximus And Tensor Fascia Lata Transfer For Primary Deficiency Of The Abductors Of The Hip

Sivashankar Chandrasekaran, MBBS, FRACS, Westmont, IL UNITED STATES
S. Pavan Vemula, MA, Westmont, IL UNITED STATES
Nader Darwish, BS, Chicago, IL UNITED STATES
Parth Lodhia CANADA
Carlos Suarez Ahedo, MD, Mexico City, DF MEXICO
Benjamin G. Domb, MD, Chicago, IL UNITED STATES

American Hip Institute, Westmont, IL, UNITED STATES

FDA Status Not Applicable

Summary: This case series suggests that gluteus maximus and TFL transfer for irreparable abductor deficiency may be effective for pain relief, improving abductor strength, and reconstructing abductor function.

Abstract:
Purpose: This study aims to present three patients’ results after undergoing gluteus maximus and tensor fascia lata (TFL) transfer for chronic abductor tears unable to be repaired primarily. Methods: Three patients were identified intra-operatively as having an abductor tear unable to be repaired primarily. The anterior third of the gluteus maximus and the posterior third of the TFL were mobilized and transferred to the greater trochanter in order to reproduce the normal force vector of the gluteus medius and minimus. Data was prospectively collected for changes in gait, abductor strength, and the following patient reported outcomes (PROs): modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score Sports Specific Subscale (HOS-SSS), Hip Outcome Score Activities of Daily Living (HOS-ADL), visual analogue scale (VAS), and satisfaction. Results: The patients were female, 63-75 years old, with BMIs of 23-28. All patients had follow-up at mean 2.1 years (1.25–2.5) with positive Trendelenburg signs preoperatively; two patients normalized postoperatively. For two patients, abductor strength improved by two grades postoperatively; the other patient maintained grade four. Two patients’ PROs all improved; the other patient’s PROs all improved except mHHS. Post-operative VAS scores were 0, 0, 1. Two patients reported maximum satisfaction. Conclusion: This case series suggests that gluteus maximus and TFL transfer for irreparable abductor deficiency may be effective for pain relief, improving abductor strength, and reconstructing abductor function. Although this is a small series, it is to our knowledge the first report of clinical outcomes of this procedure.