Limited Effects on Patient Outcomes of Conjoint Tendon Release in Anterolateral Muscle-sparing Total Hip Arthroplasty

Overview

Journal J Orthop Surg Res

Publisher Biomed Central

Specialty Orthopedics

Date 2021 Aug 11

PMID 34376238

Citations 4

Authors

Hidetatsu Tanaka

Norikazu Yamada

Hiroaki Kurishima

Yu Mori

Takashi Sakamoto

Masamizu Oyama

Toshimi Aizawa

Affiliations

Soon will be listed here.

Abstract

Background: The anterolateral muscle-sparing total hip arthroplasty (THA) in the supine position is advantageous owing to the very low-dislocation rate and excellent leg length discrepancy control. However, femur exposure is challenging. Although the conjoined external rotators tendon (CERT) release is effective in improving femoral access, the effects on clinical outcomes remain unclear. The purpose of this study was to evaluate the clinical and radiographic results of CERT release in the anterolateral muscle-sparing THA approach.

Methods: The study was performed as a retrospective cohort study and included 85 hips in 85 patients who underwent primary anterolateral THA. Clinical and radiographic outcomes were investigated 6 months and 1 year after THA (CERT-preserved and non-released patients). The Japanese Orthopaedic Association (JOA) hip score, JOA Hip-disease Evaluation Questionnaire (JHEQ), forgotten joint score (FJS), and the 36 short-form questionnaires (SF-36 mental and physical) were evaluated. The leg length discrepancy, cup inclination and stem orientation were evaluated with radiographs.

Results: Among all the included hips, 37 patients (43.5%) retained the CERT, and 48 patients (56.5%) included the released CERT. There were no significant differences in the JOA hip scores, JHEQ, FJF-12 and SF-36 between the released and non-released groups. There were significant differences in sagittal stem alignments between groups.

Conclusion: The CERT release in anterolateral muscle-sparing THA has a limited effect on post-operative clinical outcomes. The CERT release improved the femur exposure and is more invasive than the preserved CERT. We infer that the CERT should be maintained in patients with a wide range of motions, and release the CERT in inadequate femur canal preparation cases.

Citing Articles

Preserving medial iliofemoral ligament avoids excessive leg lengthening in total hip arthroplasty using anterolateral-supine approach.

Kurishima H, Yamada N, Noro A, Tanaka H, Takahashi S, Tsuchida K J Orthop. 2024; 60:29-34.

PMID: 39345678 PMC: 11437599. DOI: 10.1016/j.jor.2024.09.004.

Minimal Influence on Muscle Strength and Patient Reported Outcome Measures by Conjoined Tendon Detachment in Anterolateral Muscle-Sparing Total Hip Arthroplasty.

Tanaka H, Yamada N, Kurishima H, Mori Y, Aizawa T Indian J Orthop. 2024; 58(2):127-134.

PMID: 38312900 PMC: 10830953. DOI: 10.1007/s43465-023-01080-5.

Influence of greater trochanteric bone density and three-dimensional morphology on perioperative greater trochanteric fracture following total hip arthroplasty via an anterolateral approach.

Inoue D, Kabata T, Kajino Y, Yamamuro Y, Taninaka A, Kataoka T BMC Musculoskelet Disord. 2023; 24(1):856.

PMID: 37907894 PMC: 10619302. DOI: 10.1186/s12891-023-06988-5.

Association between Hip Center Position and Isokinetic Hip Muscle Performance after Anterolateral Muscle-Sparing Total Hip Arthroplasty.

Tanaka H, Yamada N, Kurishima H, Mori Y, Aizawa T Medicina (Kaunas). 2022; 58(4).

PMID: 35454377 PMC: 9029787. DOI: 10.3390/medicina58040538.

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