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Total Hip Arthroplasty for Ankylosis Requiring Rotational Rectus Femoris Flap and Skin Graft for Wound Closure.

ABSTRACT: We present a case report of a 51-year-old Ghanaian immigrant who underwent total hip arthroplasty in the setting of spontaneous ankylosis of unknown etiology. The increase in offset of the patient's limb through reconstruction, in combination with severe soft-tissue atrophy of the lower extremity, resulted in a soft-tissue defect that could not be closed primarily. This ultimately required a rectus femoris rotational flap and skin grafting for coverage. We describe the surgical technique used for conversion of an ankylosed hip to total hip arthroplasty, as well as the technique for management of a large proximal thigh soft-tissue defect with rectus femoris muscle flap coverage.

SUBMITTER: Kovalenko B

PROVIDER: S-EPMC7183003 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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Total Hip Arthroplasty for Ankylosis Requiring Rotational Rectus Femoris Flap and Skin Graft for Wound Closure.

Kovalenko Boris B Stein Isaac I Fernando Navin N

Arthroplasty today 20200423 2

We present a case report of a 51-year-old Ghanaian immigrant who underwent total hip arthroplasty in the setting of spontaneous ankylosis of unknown etiology. The increase in offset of the patient's limb through reconstruction, in combination with severe soft-tissue atrophy of the lower extremity, resulted in a soft-tissue defect that could not be closed primarily. This ultimately required a rectus femoris rotational flap and skin grafting for coverage. We describe the surgical technique used fo ...[more]

PMID: 32346585

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Project description:BackgroundRectus femoris injuries are common among athletes, especially in kicking sports such as soccer; however, proximal rectus femoris avulsions in athletes are a relatively rare entity.Purpose/hypothesisThe purpose of this study was to describe and report the results of an original technique of surgical excision of the proximal tendon remnant followed by a muscular suture repair. Our hypothesis was that this technique limits the risk of recurrence in high-level athletes and allows for rapid recovery without loss of quadriceps strength.Study designCase series; Level of evidence, 4.MethodsOur retrospective series included 5 players aged 31.8 ± 3.9 years with acute proximal rectus femoris avulsion injuries who underwent a surgical resection of the proximal tendon between March 2012 and June 2014. Four of these players had recurrent rectus femoris injuries in the 9 months before surgery, while 1 player had surgery after a first injury. Mean follow-up was 18.2 ± 12.6 months, and minimum follow-up was 9 months. We analyzed the age, sex distribution, physical examination outcomes, type and mechanism of injury, diagnosis, treatment and complications during surgery, postoperative follow-up, and time to return to play. The Lower Extremity Functional Scale (LEFS) and Marx scores were obtained at 3-month follow-up, and isokinetic tests were performed before return to sports. A telephone interview was completed to determine the presence of recurrence at an average follow-up of 18.2 months.ResultsAt 3-month follow-up, all patients had Marx activity scores of 16 and LEFS scores of 80. Return to the previous level of play occurred at a mean of 15.8 ± 2.6 weeks after surgery, and none of the athletes suffered a recurrence. Isokinetic test results were comparable between both sides.ConclusionThe surgical treatment of proximal rectus femoris avulsions, consisting of resection of the tendinous part of the muscle, is a reliable and safe technique allowing a fast recovery in professional athletes.

Dataset Information

Total Hip Arthroplasty for Ankylosis Requiring Rotational Rectus Femoris Flap and Skin Graft for Wound Closure.

Publications

Total Hip Arthroplasty for Ankylosis Requiring Rotational Rectus Femoris Flap and Skin Graft for Wound Closure.

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