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采用现代技术联合转移臀大肌和阔筋膜张肌治疗不可修复的臀中肌撕裂:短期疗效

Combined Transfer of the Gluteus Maximus and Tensor Fasciae Latae for Irreparable Gluteus Medius Tear Using Contemporary Techniques: Short-Term Outcomes.

作者信息

Maldonado David R, Annin Shawn, Chen Jeffrey W, Yelton Mitchell J, Shapira Jacob, Rosinsky Philip J, Lall Ajay C, Domb Benjamin G

机构信息

American Hip Institute Research Foundation, Chicago, Illinois.

Vanderbilt University School of Medicine, Nashville, Tennessee.

出版信息

JB JS Open Access. 2020 Nov 25;5(4). doi: 10.2106/JBJS.OA.20.00085. eCollection 2020 Oct-Dec.

Abstract

UNLABELLED

Combined transfer of the gluteus maximus and tensor fasciae latae (TFL) has been acknowledged as a treatment for irreparable full-thickness gluteus medius tears; yet, there is a paucity of reports on outcomes for this topic in the current literature. The purpose of the present study was to report short-term patient-reported outcome scores in patients who underwent combined transfer of the gluteus maximus and TFL in the setting of an irreparable gluteus medius tear.

METHODS

Data for patients who underwent hip preservation and hip arthroplasty between July 2011 and November 2017 were prospectively collected and retrospectively reviewed. Patients were considered for this study if they had undergone combined transfer of the gluteus maximus and TFL for irreparable gluteus medius tears. Inclusion criteria consisted of patients who had a minimum 1-year follow-up for the modified Harris hip score, Non-Arthritic Hip Score, Hip Outcome Score Sports Specific Subscale, visual analog scale score for pain, and patient satisfaction. The exclusion criterion was Workers' Compensation status.

RESULTS

The study included 18 hips in 18 patients who underwent combined transfer of the gluteus maximus and TFL, with a mean follow-up of 39.75 months (range, 12.04 to 93.88 months). The average age was 68.48 ± 11.05 years, the average body mass index was 29.54 ± 6.23 kg/m, and 13 patients were female. Abductor strength improved in 7 of 17 patients, with abduction data unavailable for 1 patient. Significant improvements were observed in modified Harris hip score from 49.73 ± 16.85 to 74.94 ± 17.91 (p < 0.001), Non-Arthritic Hip Score from 55.02 ± 22.53 to 72.78 ± 19.17 (p = 0.032), and visual analog scale for pain from 5.42 ± 3.42 to 1.57 ± 1.68 (p = 0.0004). No secondary surgeries were reported.

CONCLUSIONS

Significant improvements in patient-reported outcomes were observed in patients who underwent combined transfer of the gluteus maximus and TFL for the treatment of irreparable full-thickness gluteus medius tears at short-term follow-up.

LEVEL OF EVIDENCE

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

摘要

未标注

臀大肌和阔筋膜张肌联合转移已被公认为治疗无法修复的全层臀中肌撕裂的一种方法;然而,目前文献中关于该主题结局的报道较少。本研究的目的是报告在无法修复的臀中肌撕裂情况下接受臀大肌和阔筋膜张肌联合转移患者的短期患者报告结局评分。

方法

前瞻性收集并回顾性分析2011年7月至2017年11月期间接受保髋手术和髋关节置换术患者的数据。如果患者因无法修复的臀中肌撕裂而接受了臀大肌和阔筋膜张肌联合转移,则纳入本研究。纳入标准包括对改良Harris髋关节评分、非关节炎髋关节评分、髋关节结局评分运动特定子量表、疼痛视觉模拟量表评分和患者满意度进行至少1年随访的患者。排除标准为工伤赔偿状态。

结果

本研究纳入了18例接受臀大肌和阔筋膜张肌联合转移的患者的18个髋关节,平均随访39.75个月(范围为12.04至93.88个月)。平均年龄为68.48±11.05岁,平均体重指数为29.54±6.23kg/m²,13例为女性。17例患者中有7例外展肌力改善,1例患者无外展数据。改良Harris髋关节评分从49.73±16.85显著提高到74.94±17.91(p<0.001),非关节炎髋关节评分从55.02±22.53提高到72.78±19.17(p = 0.032),疼痛视觉模拟量表评分从5.42±3.42降低到1.57±1.68(p = 0.0004)。未报告二次手术。

结论

在短期随访中,接受臀大肌和阔筋膜张肌联合转移治疗无法修复的全层臀中肌撕裂的患者,其患者报告结局有显著改善。

证据水平

IV级。有关证据水平的完整描述,请参阅作者指南。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13d5/7757833/b1c1f9a2f034/jbjsoa-5-e20.00085-g001.jpg

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