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Vastus Lateralis Muscle Flap for High-Risk Patients Undergoing Orthopaedic Hip Surgery
Sofia E Olsson1, Isabella Amado, Arman Fijany
1From the Anne Burnett Marion School of Medicine at Texas Christian University, Fort Worth, TX (Ms. Olsson, Ms. Amado, Dr. Fijany, Ms. Soleimani, Mr. Troia, Dr. Washington and Dr. Kurapati); the Texas Health Orthopedic Specialists, Fort Worth, TX (Dr. Sanchez); and the MP Plastic Surgery, Fort Worth, TX (Dr. Pekarev).
A vastus lateralis (VL) muscle flap effectively treats complications after total hip arthroplasty (THA), preventing hip disarticulation (HD) in most patients. This muscle flap offers a promising solution for complex THA cases.
Area of Science:
- Orthopedic surgery
- Musculoskeletal reconstruction
Background:
- Chronic infections and soft-tissue defects are severe complications following total hip arthroplasty (THA).
- Hip disarticulation (HD) is a high-risk procedure with poor outcomes for these complications.
- The use of vastus lateralis (VL) muscle flaps for preventing HD after THA is unexplored.
Purpose of the Study:
- To evaluate the efficacy of an ipsilateral, pedicled vastus lateralis (VL) muscle flap in preventing hip disarticulation (HD) in patients with recurrent complications after total hip arthroplasty (THA).
Main Methods:
- Retrospective case review of 14 patients undergoing soft-tissue hip reconstruction with a VL muscle flap.
- Analysis of 6-month postoperative outcomes.
Main Results:
- 86% of patients achieved full recovery at 6 months, with preserved hip range of motion, no pain, and no ambulation weakness.
- Two patients (14%) ultimately required hip disarticulation despite VL flap intervention.
Conclusions:
- A VL muscle flap is an effective treatment for nonhealing THA complications and a prophylactic measure for patients at high risk of HD.
- The VL muscle's size, local anatomy, and vascularity make it ideal for reducing dead space and promoting healing.
- Further prospective studies are needed to define the optimal patient population for this technique.
