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Arthroscopic revision release of gluteal muscle contracture after failed primary open surgery

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Abstract

Purpose

The treatment of gluteal muscle contracture (GMC) after failed primary open release surgery has rarely been reported in the literature. GMC is a troublesome health problem in some developing countries, and it can result in the limitation of patients’ hip function, leading to the development of inferiority complexes. The aim of this study is to evaluate the effect of arthroscopic revision surgery after failed primary open release on patients with GMC.

Methods

A total of 278 hips of 140 patients who underwent arthroscopic revision procedures after failed primary open surgeries were gathered from the department files. All patients were treated using a “three-step” arthroscopic release procedure by the same surgeon group.

Results

The mean follow-up for the 136 patients was 38.9 months. There was significant difference (P < 0.05) between the patients’ mean post-revision and pre-operative results on the Harris scoring system. Unreleased contracture tissues that needed revision operations included the gluteus maximus, tensor fasciae latae muscle, and gluteus medius in all patients, and the gluteus minimus and hip capsule in 11.0% and 8.1% of patients, respectively. Short-term complications included subcutaneous bruising of the abdomen in 11 patients, extensive ecchymosis in the lateral thigh in 12 patients, and a transient reduction of muscle strength in all patients. No complications involving postoperative incision infection, nerve and blood vessel damage, or positive Trendelenburg sign occurred. Symptoms of hip snapping and limitation of range of motion (ROM), combined with a positive Trendelenburg sign in two patients after the primary open surgery, were all resolved except for the Trendelenburg sign through arthroscopic revision release. The overall satisfaction rate of the revision operations was 90.4%.

Conclusion

The three-step arthroscopic release procedure is effective for failed primary open GMC surgeries as shown by improved post-operative function and patient satisfaction regardless of which primary procedure was performed.

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Acknowledgments

All of the named authors take responsibility for the integrity of the work as a whole and have given final approval for this version to be published. We thank Huaigu Tian for his statistical and technical support.

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    Authors and Affiliations

    1. Academy of Orthopedics, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, China

      Xintao Zhang & Dadi Jin

    2. Department of Sports Medicine and Rehabilitation, Peking University Shenzhen Hospital, Shenzhen, 510086, China

      Xintao Zhang, Xiaocheng Jiang, Feilin He, Zuru Liang, Tian You & Wentao Zhang

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    1. Xintao Zhang
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    2. Xiaocheng Jiang
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    3. Feilin He
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    5. Tian You
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    7. Wentao Zhang
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    Corresponding author

    Correspondence to Wentao Zhang.

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    The authors declare that they have no conflict of interest.

    Funding

    This study was supported by Medical Scientific Research Foundation of Guangdong Province, China (Funding NO: A2015560 and A2016517).

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    This article does not contain any studies with human participants or animals performed by any of the authors.

    Additional information

    Xintao Zhang and Xiaocheng Jiang contributed equally to this work.

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    Cite this article

    Zhang, X., Jiang, X., He, F. et al. Arthroscopic revision release of gluteal muscle contracture after failed primary open surgery. International Orthopaedics (SICOT) 41, 1521–1526 (2017). https://doi.org/10.1007/s00264-016-3354-5

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    • DOI: https://doi.org/10.1007/s00264-016-3354-5

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