Incidence and treatment of abductor deficiency during total hip arthroplasty using the posterior approach: repair with direct suture technique and gluteus maximus flap transfer.
L A Whiteside, M E Roy
https://pubmed.ncbi.nlm.nih.gov/31146555Actively Recruiting
Phase Not Applicable
Age: 40Years - 80Years
All Genders
ID05206838
Achilles Tendon Homograft for the Treatment of Gluteus Medius Insufficiency After Hip Replacement
Led by Sahlgrenska University Hospital · Updated on 2025-04-08
44
Participants Needed
1
Research Sites
52 weeks
Total Duration
On this page
Sponsors
S
Sahlgrenska University Hospital
Lead Sponsor
G
Göteborg University
Collaborating Sponsor
AI-Summary
What this Trial Is About
Residual limping due to gluteus medius insufficiency after total hip replacement is a serious complication without effective treatment. This study aims to compare surgical reconstruction of the gluteus medius using an Achilles tendon allograft with non-surgical physiotherapy treatment. The hypothesis is that surgery followed by physiotherapy will improve hip function and reduce limping more than physiotherapy alone. Participants are randomly assigned to one of two groups. One group undergoes surgical reconstruction where an Achilles tendon allograft with a calcaneus block is fixed to the greater trochanter and tensioned through the gluteus medius muscle, followed by partial weight bearing for 2 months and 10 months of physiotherapy. The other group receives only physiotherapy for 12 months without surgery. Throughout the study, participants will be assessed at 12 months using the Oxford Hip Score to measure hip function. Additional evaluations include Trendelenburg's sign, hip abduction strength, activity levels, quality of life indexes, and monitoring of any adverse events. The total study duration for each participant is 12 months, with close observation of treatment outcomes and safety.
CONDITIONS
Brief Title
Achilles Tendon for the Treatment of Gluteus Medius Insufficiency
Who Can Participate
Age: 40Years - 80Years
All Genders
Eligibility Criteria
You may qualify if you...
- Persisting limping with positive Trendelenburg's sign for at least 12 months after total hip arthroplasty
- Rupture or avulsion of the gluteus medius tendon verified with ultrasound or MRI
- Leg length discrepancy less than 1 cm
- Femoral offset discrepancy less than 25%
You will not qualify if you...
- Neuromuscular disorders
AI-Screening
AI-Powered Screening
Complete this quick 3-step screening to check your eligibility
1
2
3
Your Study Journey
Screening
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Surgery and Immediate Post-operative Care
Duration - 2 months
Participants undergo surgical reconstruction of the gluteus medius using an Achilles tendon allograft fixed between the muscle and the greater trochanter, followed by immediate post-operative care including partial weight bearing.
Visits as needed during partial weight bearing period
Treatment
Duration - 10 to 12 months
Participants receive physiotherapy following surgery or physiotherapy alone if non-surgical, aimed at improving hip function and reducing limping.
Regular physiotherapy visits during this period
Trial Site Locations
Total: 1 location
1
Sahlgrenska University Hospital
Mölndal, Sweden, 431 80
Actively Recruiting
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How is the study designed?
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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Published Research Related To This Trial
Post-operative gait analysis in total hip replacement patients-a review of current literature and meta-analysis.
Alistair M Ewen, Su Stewart, Alan St Clair Gibson...
https://pubmed.ncbi.nlm.nih.gov/22410129Surgical technique: Transfer of the anterior portion of the gluteus maximus muscle for abductor deficiency of the hip.
Leo A Whiteside
https://pubmed.ncbi.nlm.nih.gov/21796476Repair of a deficient abductor mechanism with Achilles tendon allograft after total hip replacement.
Michael N Fehm, James I Huddleston, Dennis W Burke...
https://pubmed.ncbi.nlm.nih.gov/20926725Meaningful changes for the Oxford hip and knee scores after joint replacement surgery.
David J Beard, Kristina Harris, Jill Dawson...
https://pubmed.ncbi.nlm.nih.gov/25441700