Abductor avulsion after primary total hip arthroplasty. Results of repair

The results of reoperation and repair of abductor musculature avulsion that occurred as a complication of a primary total hip arthroplasty performed through an anterolateral approach were reviewed in nine patients 2 to 13.5 years (mean, 4.8) after repair. Limp was markedly decreased in five of nine patients, and need for ambulatory aids also was reduced in five of the nine. Improvement continued for 1 to 3 years after the repair. Objectively, three of the four patients (75%) without significant preoperative pain had a good or excellent result, whereas only one of five patients (20%) with significant preoperative pain had a good or excellent result. In all three cases where hip instability was a presenting symptom, it was successfully treated. Four patients felt they were much better, three felt somewhat better, and two felt they gained no improvement by repair. This information suggests that the best indications for repair are symptoms of marked abductor weakness or hip instability; significant preoperative pain is less likely to be decreased.