What happens in the medium-term to capsule-thickening plasties for iliopsoas impingement after total hip arthroplasty? Evaluation of 14 procedures at 4years' follow-up.

Autor: Martinot P; Département de Chirurgie Orthopédique, Groupement des Hôpitaux de l'Institut Catholique de Lille, Université Catholique de Lille, Lomme, France. Electronic address: pierre.martinot@hotmail.fr., Baujard A; Service d'Orthopédie, Hôpital Salengro, CHU de Lille, place de Verdun, 59000 Lille, France., Demondion X; Département d'Imagerie Musculosquelettique, Université de Lille, Centre de Consultations et d'Imagerie de l'Appareil Locomoteur (C.C.I.A.L.), CHU de Lille, rue du Professeur Émile-Laine, 59037 Lille cedex, France., Girard J; Service d'Orthopédie, Hôpital Salengro, CHU de Lille, place de Verdun, 59000 Lille, France; Université de Lille, CHU de Lille, ULR 2694 - METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, 59000 Lille, France; University of Lille, University of Artois, University Littoral Côte d'Opale, EA 7369 - Unité de Recherche Pluridisciplinaire Sport Santé Société (URePSS), 59000 Lille, France., Migaud H; Service d'Orthopédie, Hôpital Salengro, CHU de Lille, place de Verdun, 59000 Lille, France.
Jazyk: angličtina
Zdroj: Orthopaedics & traumatology, surgery & research : OTSR [Orthop Traumatol Surg Res] 2024 Sep; Vol. 110 (5), pp. 103741. Date of Electronic Publication: 2023 Nov 01.
DOI: 10.1016/j.otsr.2023.103741
Abstrakt: Introduction: In 2015, we described a capsule-thickening technique via an anterior approach for iliopsoas cup impingement. To our knowledge, medium-term results have not been reported. We therefore retrospectively analyzed all cases in the initial series and those since 2015, to assess this original technique over a longer follow-up: (1) to analyze complications, and (2) to assess functional outcome.
Hypothesis: The study hypothesis was that this surgical solution has a success rate sufficient for it to be included in the therapeutic armamentarium for iliopsoas impingement.
Material and Method: Fourteen patients were included. Nine plasties were in first line, 3 after tenotomy, and 2 after cup exchange. The anterior Hueter approach was used, visualizing anterior cup overhang, sometimes associated with penetration of the anterior capsule, and enabling capsule-thickening by a folded Vicryl™ mesh. Functional results were analyzed.
Results: At a median 4years' follow-up (IQR: 2-5; range: 1-9), change over baseline in Oxford score was 7 points (p=0.004), median Medical Research Council thigh flexion strength score was 5 (IQR: 5-5), and 50% of patients (7/14) were satisfied or very satisfied. The major complications rate was 7% (1/14), for 1 irrigation of infected hematoma, cured without recurrence; there was also 1 minor case of injury to the lateral cutaneous nerve of the thigh. Forty-three percent of patients (6/14) exhibited a minimal clinically important difference (MCID) and 64% (9/14) a patient-acceptable symptom state (PASS). Median anatomic overhang on anatomic CT transverse slice was 7mm (IQR: 3-8; range: 0-13). Four patients underwent secondary acetabular component exchange; their median overhang was 7.5mm (IQR: 7-8) compared to 5mm (IQR: 2-8) for the other patients (p-value non-calculable).
Conclusion: This surgical option seems interesting when acetabular overhang is not too great, especially as it does not affect flexion strength.
Level of Evidence: IV.
(Copyright © 2023 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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