Achilles Tendon for the Treatment of Gluteus Medius Insufficiency (HLS)

Sahlgrenska University Hospital

Status: Enrolling

Conditions: Muscle Atrophy; Muscle Weakness; Arthroplasty Complications; Muscle Tear

Treatments: Procedure: Surgical reconstruction of gluteus medius with Achilles tendon allograft

Study type: Interventional

Funder types: Other

Identifiers

NCT05206838

276262

Details and patient eligibility

About

Residual limping after total hip arthroplasty is a serious complication that lacks effective treatment. The purpose of this study is to evaluate a surgical treatment for residual limping and compare its results with non-surgical treatment. Our hypothesis is that surgical treatment followed by physiotherapy increases hip function and reduces limping compared with non-surgical treatment with physiotherapy alone.

Full description

Residual limping due to gluteus medius insufficiency after total hip arthroplasty is a serious complication that lacks effective treatment. The purpose of this study is to evaluate surgical reconstruction of gluteus medius using Achilles tendon allograft and compare its results and adverse events with non-surgical treatment. Our hypothesis is that surgical reconstruction followed by physiotherapy increases hip function and reduces limping compared with non-surgical treatment with physiotherapy alone.

Enrollment: 44 estimated patients

Sex: All

Ages: 40 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Persisting limping with positive Trendelenburg's sign for at least 12 months after total hip arthroplasty
• Rupture/avulsion of the gluteus medius tendon verified with ultrasound or MRI
• Leg length discrepancy of less than 1 cm
• Femoral offset discrepancy of less than 25%

Exclusion criteria

• Neuromuscular disorders

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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44 participants in 2 patient groups

Surgical reconstruction

Experimental group

Description:

22 patients undergo surgical reconstruction of gluteus medius with allograft consisting of Achilles tendon with calcaneus block. The calcaneus block is fixed into the greater trochanter and the Achilles tendon i passed through the gluteus medius muscle, tensioned and sutured into the muscle. Postoperatively, partial weight bearing for 2 months followed by physiotherapy for 10 months.

Treatment:

Procedure: Surgical reconstruction of gluteus medius with Achilles tendon allograft

Physiotherapy

No Intervention group

Description:

22 patients receive non-operative treatment for their limp with physiotherapy alone during a 12-month period.