Reconstruction of Chronic Abductor Deficiency after Revision Hip Arthroplasty with Extensor Mechanism Allograft

Michael Drexler Yona Kosashvilli Tim Dwyer Allan Gross Paul Kuzyk Oleg Safir
Hip and Knee recunstraction, Mount Sinai Hospital, Toronto, Canada

The purpose of the present report is to report the clinical outcome of abductor reconstruction after revision THA using a fresh-frozen knee extensor mechanism allograft. A retrospective analysis was conducted of 11 consecutive patients with severe limp secondary to an MRI confirmed abductor deficiency. The mean age of the patients was 66.7 years (range, 52 to 84 years), with a mean follow-up period of 33 months (range, 24-41 month). Following surgery, two patients (18%) had no limp, seven patients (64%) had a mild limp, and two patients (18%) continued to demonstrate severe limp (p=0.0039). Abductor power improved from mean 2.15/5 to mean 3.8 (p<0.0002). Preoperatively, all patients required the used of a cane or walker; postoperatively four patients were able to walk without an aid. Overall, 9/11 patients complained of severe/moderate pain pre-operatively; postoperatively 10 patients had no or mild pain only. At latest follow up, the Harris Hip Score was good in 5 hips (47%), fair in 2 (18%) hips, and poor in 4 (36%). We conclude that using an extensor mechanism allograft is relatively effective method of treating chronic hip abductor deficiency when options such as direct repair or local tissue transfer are not possible.