[Gluteus maximus transposition for recurrent dislocation after total hip arthroplasty]
Related Experiment Video
Updated: Nov 7, 2026
The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022
Zhiqiang Li1, Pei Yang1, Run Tian1
1Department of Bone and Joint Surgery, Orthopaedic Centre, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi, China.
Objective:
To investigate the modified gluteus maximus transfer technique for treating recurrent dislocation after total hip arthroplasty (THA) and evaluate its clinical efficacy.
Methods:
A retrospective analysis was conducted on 24 patients who underwent gluteus maximus transfer for recurrent dislocation after THA between January 2012 and December 2021. The cohort included 9 males (9 hips) and 15 females (15 hips), aged from 48 to 77 years old with a mean age of (60.21±8.30) years old. Patients with a stable prosthesis (no loosening) and preoperative and intraoperative evidence of gluteus medius injury were selected for a modified posterior gluteus maximus transfer. Intraoperatively, a muscle flap was harvested from the superior portion of the gluteus maximus. A roughened bone surface was prepared at the inferolateral aspect of the greater trochanter, where the muscle flap was secured via drill holes. Postoperative complications, including wound infection and recurrent dislocation, were recorded. The Harris hip score (HHS), Oxford hip score (OHS), and Trendelenburg test results were compared and analyzed between the preoperative baseline and the final follow-up.
Results:
All patients underwent the surgical procedure successfully and completed the follow-up. The follow-up duration ranged from 2 to 4 years, with a mean of (3.21±0.78) years. No postoperative mortality, infection, or recurrent dislocation occurred. HHS improved significantly from a preoperative mean of 31.58±7.35 to a postoperative mean of 71.71±9.49 (t=-31.63, P<0.05). Similarly, OHS increased from a preoperative mean of 21.38±5.61 to 38.88±7.97 at the final follow-up (t=-15.32, P<0.05). Regarding the Trendelenburg test, 17 patients were unable to complete the test and 7 tested positive preoperatively. At the final follow-up, 19 patients tested negative, 4 tested positive, and 1 was unable to complete the test. This postoperative improvement was statistically significant compared to preoperative baseline (χ2=34.04, P<0.05).
Conclusion:
The modified gluteus maximus transfer technique is a safe and effective treatment for recurrent dislocation caused by abductor insufficiency following THA.
