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ABductor tendon tears
A Thread
#orthotwitter #medtwitter
Thanks @CenterRotation and @kimtuckinAZ for the idea for this thread
A Thread
#orthotwitter #medtwitter
Thanks @CenterRotation and @kimtuckinAZ for the idea for this thread
Commonly present with LATERAL hip pain. Often treated for months if not years as trochanteric bursitis
NSAIDS, injections, PT - all typically fail to relieve symptoms
Classically injections provide short term relief (days) and pain returns
C/O pain, instability, weakness
NSAIDS, injections, PT - all typically fail to relieve symptoms
Classically injections provide short term relief (days) and pain returns
C/O pain, instability, weakness
On exam patients are tender to palpation over lateral hip (as with troch bursitis
They are unable to perform a single leg stance or have severe pain while doing so
Some will have a trendelenburg gait
They are unable to perform a single leg stance or have severe pain while doing so
Some will have a trendelenburg gait
MRI or U/S will confirm diagnosis
These tears often see us - but we don't see them unless we are looking
These tears often see us - but we don't see them unless we are looking
You can manage small and undersurface tears with arthroscopy. We typically treat them open to fully mobilize the tissue and achieve good fixation.
Our technique.
Our technique.
For large chronic tears, or poor tissue I have augmented the repair with a bioinductive implant (type I collagen) with good success (REGENETEN)
Post-operatively patients are TDWB x 6 weeks, then we advance them to WBAT on a walker with PT
They advance to a cane when ready and remain on a cane until their limp has resolved
They advance to a cane when ready and remain on a cane until their limp has resolved
I educate patients extensively that the rehab is very extensive and time consuming. Returning to PT at 6 weeks patients encounter an increase in pain / soreness which is expected and resolves with time. Results have been excellent and we hope to publish them soon
