Drexler Michael, Dwyer Tim, Kosashvili Yona, Chakravertty Rajesh, Abolghasemian Mansuor, Gollish Jeffrey
Holland Orthopaedic & Arthritic Centre, Sunnybrook Health Sciences Centre, Toronto, Canada.
Women's College Hospital, University of Toronto Orthopaedic Sports Medicine, Toronto, Canada.
J Arthroplasty. 2014 May;29(5):1052-7. doi: 10.1016/j.arth.2013.09.056. Epub 2013 Oct 7.
We report on 17 patients with massive abductor avulsions after total hip arthroplasty (THA) treated with medialization of the acetabular component and tensor fascia lata (TFL) reconstruction. All patients had severe limp, positive Trendelenburg sign, and avulsion of the abductor insertion confirmed on MRI. Mean age was 69 years (range, 50-83 years), and mean follow-up period was 36 months (range, 18-78 months). After surgery, 9 patients had no limp (47%), 8 patients had a mild limp, and abductor power improved from mean 2.5/5 to mean 3.8 (P < 0.0001). At latest follow-up, the Harris Hip Score was excellent in 6 hips (37%), good in 7 (43%) hips, and fair or poor in 3 (23%). Two patients with mild limp were not satisfied with their procedure.
我们报告了17例全髋关节置换术（THA）后出现大转子撕脱的患者，采用髋臼组件内移和阔筋膜张肌（TFL）重建进行治疗。所有患者均有严重跛行、Trendelenburg征阳性，且MRI证实外展肌止点撕脱。平均年龄为69岁（范围50 - 83岁），平均随访期为36个月（范围18 - 78个月）。术后，9例患者无跛行（47%），8例患者有轻度跛行，外展肌力从平均2.5/5提高到平均3.8（P < 0.0001）。在最近一次随访时，Harris髋关节评分在6髋（37%）为优秀，7髋（43%）为良好，3髋（23%）为一般或较差。2例轻度跛行患者对手术不满意。
