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Włodzimierz Samborski - One of the best experts on this subject based on the ideXlab platform.
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Samples of a single MRI slice with contouring of the four segmented Muscles (axial view).
2016Co-Authors: Elżbieta Skorupska, Michał Rychlik, Przemysław Keczmer, Rafał M. Łochowski, Paulina Tomal, Włodzimierz SamborskiAbstract:Legend: Glut min–Gluteus Minimus Muscle, Glut med–Gluteus medius Muscle, Glut max–Gluteus maximus Muscle, Pir–piriformis Muscle. Muscles were contoured in ITK-SNAP where the structures were outlined slice-by-slice by pointing and clicking with a mouse. The program connected the consecutive points with lines.
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Sample of a single MRI slice with final segmentation of the four chosen Muscles.
2016Co-Authors: Elżbieta Skorupska, Michał Rychlik, Przemysław Keczmer, Rafał M. Łochowski, Paulina Tomal, Włodzimierz SamborskiAbstract:Legend: Glut min–Gluteus Minimus Muscle, Glut med–Gluteus medius Muscle, Glut max–Gluteus maximus Muscle, Pir–piriformis Muscle. All anatomical objects defined by closed contours were filled in by selected colors.
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Validation and Test-Retest Reliability of New Thermographic Technique Called Thermovision Technique of Dry Needling for Gluteus Minimus Trigger Points in Sciatica Subjects and TrPs-Negative Healthy Volunteers.
BioMed research international, 2015Co-Authors: Elżbieta Skorupska, Michał Rychlik, Włodzimierz SamborskiAbstract:The aim of this study was to assess the validity and test-retest reliability of Thermovision Technique of Dry Needling (TTDN) for the Gluteus Minimus Muscle. TTDN is a new thermography approach used to support trigger points (TrPs) diagnostic criteria by presence of short-term vasomotor reactions occurring in the area where TrPs refer pain. Method. Thirty chronic sciatica patients (n=15 TrP-positive and n=15 TrPs-negative) and 15 healthy volunteers were evaluated by TTDN three times during two consecutive days based on TrPs of the Gluteus Minimus Muscle confirmed additionally by referred pain presence. TTDN employs average temperature (Tavr), maximum temperature (Tmax), low/high isothermal-area, and autonomic referred pain phenomenon (AURP) that reflects vasodilatation/vasoconstriction. Validity and test-retest reliability were assessed concurrently. Results. Two components of TTDN validity and reliability, Tavr and AURP, had almost perfect agreement according to κ (e.g., thigh: 0.880 and 0.938; calf: 0.902 and 0.956, resp.). The sensitivity for Tavr, Tmax, AURP, and high isothermal-area was 100% for everyone, but specificity of 100% was for Tavr and AURP only. Conclusion. TTDN is a valid and reliable method for Tavr and AURP measurement to support TrPs diagnostic criteria for the Gluteus Minimus Muscle when digitally evoked referred pain pattern is present.
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Intensive vasodilatation in the sciatic pain area after dry needling
BMC complementary and alternative medicine, 2015Co-Authors: Elżbieta Skorupska, Michał Rychlik, Włodzimierz SamborskiAbstract:Short-term vasodilatation in the pain area after dry needling (DN) of active trigger points (TrPs) was recorded in several cases of sciatica. Moreover, the presence of TrPs in sciatica patients secondary to primary lesion was suggested. Still, it is not known how often they occur and if every TrPs can provoke vasomotor reactions. The purpose of this study was to evaluate the prevalence of active TrPs among subacute sciatica patients and the response to DN under infrared thermovision (IRT) camera control. Fifty consecutive Caucasian patients (mean age 41.2 ± 9.1y) with subacute sciatica were diagnosed towards Gluteus Minimus TrPs co-existence. Based on TrPs confirmation, patients were divided into two groups: TrPs-positive and TrPs-negative, than DN under IRT control was performed. Skin temperature changes and the percentage size of vasomotor reactions in the pain area were evaluated if present. The prevalence of active TrPs was 32.0%. Every TrPs-positive presented vasodilatation dependent on TrPs co-diagnosis (r = 0.72 p < 0.000) and pain recognition during DN (r = 0.4 p < 0.05). The size of vasodilatation in TrPs-positive subjects was: post-DN 12.3 ± 4.0% and post-observation 22.1 ± 6.1% (both p = 0.000) versus TrPs-negative: post-DN 0.4 ± 0.3% and post-observation 0.4 ± 0.2%. A significant temperature increase in the thigh and calf was confirmed for TrPs-positive subjects only (both p < 0.05). Post-DN and post-observation temperatures were as follows: average (thigh:1.2 ± 0.2°C; 1.4 ± 0.2°C, both p < 0.05 and calf: 0.4 ± 0.2°C; 0.4 ± 0.3°C, both p < 0.05) and maximum (thigh 1.4 ± 0.3°C 1.6 ± 0.3°C; both p < 0.05). The presence of active TrPs within the Gluteus Minimus Muscle among subacute sciatica subjects was confirmed. Every TrPs-positive sciatica patient presented DN related vasodilatation in the area of referred pain. The presence of vasodilatation suggests the involvement of sympathetic nerve activity in myofascial pain pathomechanism. Although the clinical meaning of TrPs in subacute sciatica patients is possible, further studies on a bigger group of patients are still required. Australian New Zealand Clinical Trials Registry ACTRN12614001060639. Registered 3 October 2014.
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Trigger point-related sympathetic nerve activity in chronic sciatic leg pain: a case study
Acupuncture in medicine : journal of the British Medical Acupuncture Society, 2014Co-Authors: Elżbieta Skorupska, Michał Rychlik, Wiktoria Pawelec, Agata Bednarek, Włodzimierz SamborskiAbstract:Sciatica has classically been associated with irritation of the sciatic nerve by the vertebral disc and consequent inflammation. Some authors suggest that active trigger points in the Gluteus Minimus Muscle can refer pain in similar way to sciatica. Trigger point diagnosis is based on Travel and Simons criteria, but referred pain and twitch response are significant confirmatory signs of the diagnostic criteria. Although vasoconstriction in the area of a latent trigger point has been demonstrated, the vasomotor reaction of active trigger points has not been examined. We report the case of a 22-year-old Caucasian European man who presented with a 3-year history of chronic sciatic-type leg pain. In the third year of symptoms, coexistent myofascial pain syndrome was diagnosed. Acupuncture needle stimulation of active trigger points under infrared thermovisual camera showed a sudden short-term vasodilatation (an autonomic phenomenon) in the area of referred pain. The vasodilatation spread from 0.2 to 171.9 cm(2) and then gradually decreased. After needling, increases in average and maximum skin temperature were seen as follows: for the thigh, changes were +2.6°C (average) and +3.6°C (maximum); for the calf, changes were +0.9°C (average) and +1.4°C (maximum). It is not yet known whether the vasodilatation observed was evoked exclusively by dry needling of active trigger points. The complex condition of the patient suggests that other variables might have influenced the infrared thermovision camera results. We suggest that it is important to check if vasodilatation in the area of referred pain occurs in all patients with active trigger points.
Robert T. Trousdale - One of the best experts on this subject based on the ideXlab platform.
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The Frank Stinchfield Award: Muscle damage after total hip arthroplasty done with the two-incision and mini-posterior techniques.
Clinical orthopaedics and related research, 2005Co-Authors: Rodrigo Mardones, Mark W. Pagnano, Joseph P. Nemanich, Robert T. TrousdaleAbstract:Some surgeons have suggested that a minimally invasive two-incision approach allows total hip arthroplasty to be done without cutting or damaging any Muscle or tendon. To our knowledge that claim has not been supported by any published clinical or basic science data. Our purpose in doing this study was to quantify the extent and location of damage to the abductor and external rotator Muscles and tendons after two-incision and mini-posterior total hip arthroplasty. Ten cadavers (20 hips) were studied. In each cadaver one hip randomly was assigned to the two-incision group and the contralateral hip was assigned to the mini-posterior group. After inserting the total hip arthroplasty components the Muscle damage was assessed using a technique described previously. Damage to the Muscle of the Gluteus medius and Gluteus Minimus was substantially greater with the two-incision technique than with the mini-posterior technique. Every two-incision total hip replacement caused measurable damage to the abductors, the external rotators, or both. Every mini-posterior hip replacement caused the external rotators to detach during the exposure and had additional measurable damage to the abductor Muscles and tendon. We do not support the contention that a two-incision total hip arthroplasty is done without cutting Muscle or tendon. None of the two-incision hip replacements were done without cutting, reaming, or damaging the Gluteus medius or Gluteus Minimus Muscle or external rotators.
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Muscle damage after total hip arthroplasty done with the two-incision and mini-posterior techniques : The treatment of osteoarthritis of the hip 1920
Clinical Orthopaedics and Related Research, 2005Co-Authors: Rodrigo Mardones, Mark W. Pagnano, Joseph P. Nemanich, Robert T. TrousdaleAbstract:Some surgeons have suggested that a minimally invasive two': incision approach allows total hip arthroplasty to be done without cutting or damaging any Muscle or tendon. To our knowledge that claim has not been supported by any published clinical or basic science data. Our purpose in doing this study was to quantify the extent and location of damage to the abductor and external rotator Muscles and tendons after two-incision and mini-posterior total hip arthroplasty. Ten cadavers (20 hips) were studied. In each cadaver one hip randomly was assigned to the two-incision group and the contralateral hip was assigned to the mini-posterior group. After inserting the total hip arthroplasty components the Muscle damage was assessed using a technique described previously. Damage to the Muscle of the Gluteus medius and Gluteus Minimus was substantially greater with the two' incision technique than with the mini-posterior technique. Every two-incision total hip replacement caused measurable damage to the abductors, the external rotators, or both. Every mini-posterior hip replacement caused the external rotators to detach during the exposure and had additional measurable damage to the abductor Muscles and tendon. We do not support the contention that a two-incision total hip arthroplasty is done without cutting Muscle or tendon. None of the two-incision hip replacements were done without cutting, reaming, or damaging the Gluteus medius or Gluteus Minimus Muscle or external rotators.
Reinhold Ganz - One of the best experts on this subject based on the ideXlab platform.
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The Anterior Approach to Hip and Pelvis
Orthopaedics and Traumatology, 2002Co-Authors: Martin Weber, Reinhold GanzAbstract:Objective Exposure of the anterior pelvic column and the anterior hip in the internervous plane between the femoral nerve (sartorius and rectus Muscle) and the superior gluteal nerve (tensor fasciae latae, Gluteus medius, and Gluteus Minimus Muscle) as well as between the blood supply of the external (medial) and internal iliac artery (lateral). Indications All pelvic osteotomies. Shelf procedures. Anterior labral lesions. Fractures of the femoral head, anterior column, anterior acetabular wall, and high transverse acetabular fractures. Contraindications None. Surgical Technique Incision along the iliac crest, over the anterosuperior iliac spine to the lateral aspect of the proximal thigh. Separation of sartorius and tensor fasciae latae. Osteotomy and medial reflection of the anterosuperior iliac spine. Subperiosteal detachment of the abdominal Muscles and the iliacus Muscle. Division of both origins of the rectus. Elevation of the iliocapsular Muscle and the psoas tendon. Incision and medial retraction of the periosteum at the anterior surface of the anterior acetabular wall to exposure the acetabular floor. Detachment of the tensor fasciae latae, Gluteus medius, and Gluteus Minimus Muscles to expose the outer ilium. Results To date, this modified Smith-Petersen approach has been used in approximately 700 periacetabular osteotomies. Complications: transient femoral (n = 1), sciatic (n = 5), and lateral femorocutaneous (30%) nerve deficits. Distal aspect of the scar always large, revision rare (n = 3). No vascular injuries. Resection of heterotopic ossification in five of six patients. Very low rates of infection, hematoma, deep thrombophlebitis, and embolism.
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The Anterior Approach to Hip and Pelvis Modified Smith-Petersen Approach and its Possibilities for Extension
2002Co-Authors: Martin Weber, Reinhold GanzAbstract:Objective Exposure of the anterior pelvic column and the anterior hip in the internervous plane between the femoral nerve (sartorius and rectus Muscle) and the superior gluteal nerve (tensor fasciae latae, Gluteus medius, and Gluteus Minimus Muscle) as well as between the blood supply of the external (medial) and internal iliac artery (lateral). Indications All pelvic osteotomies. Shelf procedures. Anterior labral lesions. Fractures of the femoral head, anterior column, anterior acetabular wall, and high transverse acetabular fractures. Contraindications None. Surgical Technique Incision along the iliac crest, over the anterosuperior iliac spine to the lateral aspect of the proximal thigh. Separation of sartorius and tensor fasciae latae. Osteotomy and medial reflection of the anterosuperior iliac spine. Subperiosteal detachment of the abdominal Muscles and the iliacus Muscle. Division of both origins of the rectus. Elevation of the iliocapsular Muscle and the psoas tendon. Incision and medial retraction of the periosteum at the anterior surface of the anterior acetabular wall to expose the acetabular floor. Detachment of the tensor fasciae latae, Gluteus medius, and Gluteus Minimus Muscles to expose the outer ilium. Results To date, this modified Smith-Petersen approach has been used in approximately 700 periacetabular osteotomies. Complications: transient femoral (n = 1), sciatic (n = 5), and lateral femorocutaneous (30%) nerve deficits. Distal aspect of the scar always large, revision rare (n = 3). No vascular injuries. Resection of heterotopic ossification in five of six patients. Very low rates of infection, hematoma, deep thrombophlebitis, and embolism.
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Gluteus Minimus-induced femoral head deformation in dysplasia of the hip
Acta orthopaedica Scandinavica, 2001Co-Authors: Martin Beck, Allan Woo, Michael Leunig, Reinhold GanzAbstract:Lateral notching of the femoral head is considered pathognomonic for spastic subluxation of the hip. Less frequently, flattening is seen with extrusion of the femoral head in nonspastic hip dysplasia. The aim of this study was to throw light on its underlying pathomechanism. On the radiographs of 297 hips with developmental dysplasia, lateral flattening of the femoral head was seen in 18 hips (6%), but notching was present in only 1. Of 7 dysplasias due to cerebral palsy, 6 showed lateral notching. The Gluteus Minimus was felt to be responsible for the lateral femoral head changes as the Muscle counteracts lateral migration of the femoral head. Intraoperative dissection of 3 hips supported this view. 1 hip with developmental dysplasia and lateral notching was subjected to a periacetabular osteotomy. At surgery, the tendon of the Gluteus Minimus was found to fit tightly into the notch. Of 2 hips with spastic dysplasia, 1 presented with and the other without lateral notching. In the hip with lateral notching, the Gluteus Minimus had a normal appearance and it lay in the defect of the femoral head. In the hip without notching, the Gluteus Minimus was atrophied with signs of fatty degeneration. We therefore believe that lateral notching is a sign of hypertonicity of the Gluteus Minimus Muscle.
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the anatomy and function of the Gluteus Minimus Muscle
Journal of Bone and Joint Surgery-british Volume, 2000Co-Authors: Martin Beck, John B Sledge, Emmanuel Gautier, Claudio Dora, Reinhold GanzAbstract:In order to investigate the functional anatomy of Gluteus Minimus we dissected 16 hips in fresh cadavers. The Muscle originates from the external aspect of the ilium, between the anterior and inferior gluteal lines, and also at the sciatic notch from the inside of the pelvis where it protects the superior gluteal nerve and artery. It inserts anterosuperiorly into the capsule of the hip and continues to its main insertion on the greater trochanter. Based on these anatomical findings, a model was developed using plastic bones. A study of its mechanics showed that Gluteus Minimus acts as a flexor, an abductor and an internal or external rotator, depending on the position of the femur and which part of the Muscle is active. It follows that one of its functions is to stabilise the head of the femur in the acetabulum by tightening the capsule and applying pressure on the head. Careful preservation or reattachment of the tendon of Gluteus Minimus during surgery on the hip is strongly recommended.
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Trochanteric flip osteotomy for cranial extension and Muscle protection in acetabular fracture fixation using a Kocher-Langenbeck approach.
Journal of orthopaedic trauma, 1998Co-Authors: Klaus A. Siebenrock, Emanuel Gautier, Reinhold GanzAbstract:OBJECTIVE: To describe the advantages and surgical technique of a trochanteric flip osteotomy in combination with a Kocher-Langenbeck approach for the treatment of selected acetabular fractures. DESIGN: Consecutive series, teaching hospital. METHODS: Through mobilization of the vastus lateralis Muscle, a slice of the greater trochanter with the attached Gluteus medius Muscle can be flipped anteriorly. The Gluteus Minimus Muscle can then be easily mobilized, giving free access to the posterosuperior and superior acetabular wall area. Damage to the abductor Muscles by vigorous retraction can be avoided, potentially resulting in less ectopic ossification. Ten consecutive cases of acetabular fractures treated with this approach are reported. In eight cases, an anatomic reduction was achieved; in the remaining two cases with severe comminution, the reduction was within one to three millimeters. The trochanteric fragment was fixed with two 3.5-millimeter cortical screws. RESULTS: All osteotomies healed in anatomic position within six to eight weeks postoperatively. Abductor strength was symmetric in eight patients and mildly reduced in two patients. Heterotopic ossification was limited to Brooker classes 1 and 2 without functional impairment at an average follow-up of twenty months. No femoral head necrosis was observed. CONCLUSION: This technique allows better visualization, more accurate reduction, and easier fixation of cranial acetabular fragments. Cranial migration of the greater trochanter after fixation with two screws is unlikely to occur because of the distal pull of the vastus lateralis Muscle, balancing the cranial pull of the Gluteus medius Muscle.
Elżbieta Skorupska - One of the best experts on this subject based on the ideXlab platform.
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Samples of a single MRI slice with contouring of the four segmented Muscles (axial view).
2016Co-Authors: Elżbieta Skorupska, Michał Rychlik, Przemysław Keczmer, Rafał M. Łochowski, Paulina Tomal, Włodzimierz SamborskiAbstract:Legend: Glut min–Gluteus Minimus Muscle, Glut med–Gluteus medius Muscle, Glut max–Gluteus maximus Muscle, Pir–piriformis Muscle. Muscles were contoured in ITK-SNAP where the structures were outlined slice-by-slice by pointing and clicking with a mouse. The program connected the consecutive points with lines.
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Sample of a single MRI slice with final segmentation of the four chosen Muscles.
2016Co-Authors: Elżbieta Skorupska, Michał Rychlik, Przemysław Keczmer, Rafał M. Łochowski, Paulina Tomal, Włodzimierz SamborskiAbstract:Legend: Glut min–Gluteus Minimus Muscle, Glut med–Gluteus medius Muscle, Glut max–Gluteus maximus Muscle, Pir–piriformis Muscle. All anatomical objects defined by closed contours were filled in by selected colors.
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Validation and Test-Retest Reliability of New Thermographic Technique Called Thermovision Technique of Dry Needling for Gluteus Minimus Trigger Points in Sciatica Subjects and TrPs-Negative Healthy Volunteers.
BioMed research international, 2015Co-Authors: Elżbieta Skorupska, Michał Rychlik, Włodzimierz SamborskiAbstract:The aim of this study was to assess the validity and test-retest reliability of Thermovision Technique of Dry Needling (TTDN) for the Gluteus Minimus Muscle. TTDN is a new thermography approach used to support trigger points (TrPs) diagnostic criteria by presence of short-term vasomotor reactions occurring in the area where TrPs refer pain. Method. Thirty chronic sciatica patients (n=15 TrP-positive and n=15 TrPs-negative) and 15 healthy volunteers were evaluated by TTDN three times during two consecutive days based on TrPs of the Gluteus Minimus Muscle confirmed additionally by referred pain presence. TTDN employs average temperature (Tavr), maximum temperature (Tmax), low/high isothermal-area, and autonomic referred pain phenomenon (AURP) that reflects vasodilatation/vasoconstriction. Validity and test-retest reliability were assessed concurrently. Results. Two components of TTDN validity and reliability, Tavr and AURP, had almost perfect agreement according to κ (e.g., thigh: 0.880 and 0.938; calf: 0.902 and 0.956, resp.). The sensitivity for Tavr, Tmax, AURP, and high isothermal-area was 100% for everyone, but specificity of 100% was for Tavr and AURP only. Conclusion. TTDN is a valid and reliable method for Tavr and AURP measurement to support TrPs diagnostic criteria for the Gluteus Minimus Muscle when digitally evoked referred pain pattern is present.
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Intensive vasodilatation in the sciatic pain area after dry needling
BMC complementary and alternative medicine, 2015Co-Authors: Elżbieta Skorupska, Michał Rychlik, Włodzimierz SamborskiAbstract:Short-term vasodilatation in the pain area after dry needling (DN) of active trigger points (TrPs) was recorded in several cases of sciatica. Moreover, the presence of TrPs in sciatica patients secondary to primary lesion was suggested. Still, it is not known how often they occur and if every TrPs can provoke vasomotor reactions. The purpose of this study was to evaluate the prevalence of active TrPs among subacute sciatica patients and the response to DN under infrared thermovision (IRT) camera control. Fifty consecutive Caucasian patients (mean age 41.2 ± 9.1y) with subacute sciatica were diagnosed towards Gluteus Minimus TrPs co-existence. Based on TrPs confirmation, patients were divided into two groups: TrPs-positive and TrPs-negative, than DN under IRT control was performed. Skin temperature changes and the percentage size of vasomotor reactions in the pain area were evaluated if present. The prevalence of active TrPs was 32.0%. Every TrPs-positive presented vasodilatation dependent on TrPs co-diagnosis (r = 0.72 p < 0.000) and pain recognition during DN (r = 0.4 p < 0.05). The size of vasodilatation in TrPs-positive subjects was: post-DN 12.3 ± 4.0% and post-observation 22.1 ± 6.1% (both p = 0.000) versus TrPs-negative: post-DN 0.4 ± 0.3% and post-observation 0.4 ± 0.2%. A significant temperature increase in the thigh and calf was confirmed for TrPs-positive subjects only (both p < 0.05). Post-DN and post-observation temperatures were as follows: average (thigh:1.2 ± 0.2°C; 1.4 ± 0.2°C, both p < 0.05 and calf: 0.4 ± 0.2°C; 0.4 ± 0.3°C, both p < 0.05) and maximum (thigh 1.4 ± 0.3°C 1.6 ± 0.3°C; both p < 0.05). The presence of active TrPs within the Gluteus Minimus Muscle among subacute sciatica subjects was confirmed. Every TrPs-positive sciatica patient presented DN related vasodilatation in the area of referred pain. The presence of vasodilatation suggests the involvement of sympathetic nerve activity in myofascial pain pathomechanism. Although the clinical meaning of TrPs in subacute sciatica patients is possible, further studies on a bigger group of patients are still required. Australian New Zealand Clinical Trials Registry ACTRN12614001060639. Registered 3 October 2014.
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Trigger point-related sympathetic nerve activity in chronic sciatic leg pain: a case study
Acupuncture in medicine : journal of the British Medical Acupuncture Society, 2014Co-Authors: Elżbieta Skorupska, Michał Rychlik, Wiktoria Pawelec, Agata Bednarek, Włodzimierz SamborskiAbstract:Sciatica has classically been associated with irritation of the sciatic nerve by the vertebral disc and consequent inflammation. Some authors suggest that active trigger points in the Gluteus Minimus Muscle can refer pain in similar way to sciatica. Trigger point diagnosis is based on Travel and Simons criteria, but referred pain and twitch response are significant confirmatory signs of the diagnostic criteria. Although vasoconstriction in the area of a latent trigger point has been demonstrated, the vasomotor reaction of active trigger points has not been examined. We report the case of a 22-year-old Caucasian European man who presented with a 3-year history of chronic sciatic-type leg pain. In the third year of symptoms, coexistent myofascial pain syndrome was diagnosed. Acupuncture needle stimulation of active trigger points under infrared thermovisual camera showed a sudden short-term vasodilatation (an autonomic phenomenon) in the area of referred pain. The vasodilatation spread from 0.2 to 171.9 cm(2) and then gradually decreased. After needling, increases in average and maximum skin temperature were seen as follows: for the thigh, changes were +2.6°C (average) and +3.6°C (maximum); for the calf, changes were +0.9°C (average) and +1.4°C (maximum). It is not yet known whether the vasodilatation observed was evoked exclusively by dry needling of active trigger points. The complex condition of the patient suggests that other variables might have influenced the infrared thermovision camera results. We suggest that it is important to check if vasodilatation in the area of referred pain occurs in all patients with active trigger points.
Rodrigo Mardones - One of the best experts on this subject based on the ideXlab platform.
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The Frank Stinchfield Award: Muscle damage after total hip arthroplasty done with the two-incision and mini-posterior techniques.
Clinical orthopaedics and related research, 2005Co-Authors: Rodrigo Mardones, Mark W. Pagnano, Joseph P. Nemanich, Robert T. TrousdaleAbstract:Some surgeons have suggested that a minimally invasive two-incision approach allows total hip arthroplasty to be done without cutting or damaging any Muscle or tendon. To our knowledge that claim has not been supported by any published clinical or basic science data. Our purpose in doing this study was to quantify the extent and location of damage to the abductor and external rotator Muscles and tendons after two-incision and mini-posterior total hip arthroplasty. Ten cadavers (20 hips) were studied. In each cadaver one hip randomly was assigned to the two-incision group and the contralateral hip was assigned to the mini-posterior group. After inserting the total hip arthroplasty components the Muscle damage was assessed using a technique described previously. Damage to the Muscle of the Gluteus medius and Gluteus Minimus was substantially greater with the two-incision technique than with the mini-posterior technique. Every two-incision total hip replacement caused measurable damage to the abductors, the external rotators, or both. Every mini-posterior hip replacement caused the external rotators to detach during the exposure and had additional measurable damage to the abductor Muscles and tendon. We do not support the contention that a two-incision total hip arthroplasty is done without cutting Muscle or tendon. None of the two-incision hip replacements were done without cutting, reaming, or damaging the Gluteus medius or Gluteus Minimus Muscle or external rotators.
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Muscle damage after total hip arthroplasty done with the two-incision and mini-posterior techniques : The treatment of osteoarthritis of the hip 1920
Clinical Orthopaedics and Related Research, 2005Co-Authors: Rodrigo Mardones, Mark W. Pagnano, Joseph P. Nemanich, Robert T. TrousdaleAbstract:Some surgeons have suggested that a minimally invasive two': incision approach allows total hip arthroplasty to be done without cutting or damaging any Muscle or tendon. To our knowledge that claim has not been supported by any published clinical or basic science data. Our purpose in doing this study was to quantify the extent and location of damage to the abductor and external rotator Muscles and tendons after two-incision and mini-posterior total hip arthroplasty. Ten cadavers (20 hips) were studied. In each cadaver one hip randomly was assigned to the two-incision group and the contralateral hip was assigned to the mini-posterior group. After inserting the total hip arthroplasty components the Muscle damage was assessed using a technique described previously. Damage to the Muscle of the Gluteus medius and Gluteus Minimus was substantially greater with the two' incision technique than with the mini-posterior technique. Every two-incision total hip replacement caused measurable damage to the abductors, the external rotators, or both. Every mini-posterior hip replacement caused the external rotators to detach during the exposure and had additional measurable damage to the abductor Muscles and tendon. We do not support the contention that a two-incision total hip arthroplasty is done without cutting Muscle or tendon. None of the two-incision hip replacements were done without cutting, reaming, or damaging the Gluteus medius or Gluteus Minimus Muscle or external rotators.