2017 ISAKOS Biennial Congress ePoster #708

 

“L” Shape Arthroscopic Release in Gluteal Muscle Contracture: A New Minimally Invasive Technique

Xiangyu Tang, MD, Beijing CHINA
Chunbao Li, MD, PHD, Beijing CHINA
Wei Qi, MD, PhD, Beijing CHINA
Feng Qu, MD, Beijing CHINA
Yujie Liu, MD, Beijing CHINA

301 Hospitail, Beijing, CHINA

FDA Status Not Applicable

Summary

The study reported a “L” shape arthroscopic release around greater trochanter of femur, which was a new minimally invasive method in arthroscopic surgery

Abstract

Purpose

Gluteal muscle contracture is common after repeated intramuscular injections, surgery is necessary in severe cases. Massive release was always needed on the basis of the extent of contractile band, which would resulted in muscular weakness, wound hematoma, long-time surgery, even neurovascular injuries. The study reported a “L” shape release around greater trochanter of femur, which was a new minimally invasive method in arthroscopic surgery.
Method: We retrospectively reviewed 148 patients with bilateral gluteal muscle contracture (67 males, 81 females) with mean age of 20.1±5.4 years old (17 to 40 years old), each patient had the history of repeated intramuscular injections. The follow signs were positive in all the patients before surgery: squatting and crouching disability, difficulty in crossing the leg, Ober’s sign, clicking sound during rotation of the hip. In the arthroscopic surgery, the contractile band was transversely released nearly under the greater trochanter at first, then longitudinal release nearly interior of the greater trochanter was operated accoding to Ober’s sign, clicking sound and muscular tension, these shaped as “L”. The functional score of gluteal muscle contracture (FGMC) was evaluated before surgery and at the last follow-up.
Results: The total average operating time was 61min±9.8min, the average operating time for one side of gluteal muscle contracture under arthroscope was 12min±3.5min. All the patients were followed a minimum of 1 years after operation, at the last follow-up, all could crouch with both knees close to each other, sit with their legs crossed, had no Ober’s sign or clicking sound during rotation of the hip. There was no neurovascular injury, recurrent contracture of the hip abductor, residual hip pain. There was one case of wound hematoma. Two patients occured muscular weakness (?level). FGMC was improved from 49.0 (23 to 71) before surgery to 90.7 (82 to 100) at last follow-up.
Conclusion: “L” shape arthroscopic release in gluteal muscle contracture can lead to less interference of the muscle, less operation time, and it is a new minimally invasive method under arthroscope.