Arthroscopic C-Shaped Release Around the Greater Trochanter for Gluteal Muscle Contracture.
OBJECTIVE
To investigate the outcomes of C-shaped release around the greater trochanter in gluteal muscle contracture under arthroscopy.


METHODS
From December 2016 to January 2018, 185 patients with gluteal muscle contracture who treated under arthroscopy were reviewed, including 69 males and 116 females. All patients had a history of repeated intramuscular injection into the buttocks. The follow signs were positive in all the patients before surgery: squatting and crouching disability, difficulty in crossing the leg, Ober's sign positive, clicking sound during rotation of the hip. The C-shaped release around the greater trochanter under arthroscopy was performed in 96 cases (C-shaped release group) with an average age of 24.6 ± 4.9 years old, and conventional gluteal muscle contracture release under arthroscopy was performed in 89 cases (conventional release group) with an average age of 25.1 ± 5.0 years. The released tissues in the C-shaped release group: iliotibial band (ITB) about 5 cm distal to the proximal end of the greater trochanter, the contracture tissue near the posterior and superior of the greater trochanter, which depended on both intraoperative physical examination and arthroscopic observation. The released tissues in conventional release group: the contracture tissues in gluteal muscles according to observation under arthroscopy. The gluteal muscle contracture disability scale (GDS) and Visual analogue scale (VAS) were evaluated before surgery and at the last follow-up.


RESULTS
The average release time after making arthroscopic operation space for each lower limb were 12.2 ± 3.2 min in the C-shaped release group, and 21.4 ± 6.1 min in the conventional release group (P = 0.000). All the patients were followed for at least of 2 years after operation. There was one case of wound hematoma in the C-shaped release group and five cases in the conventional release group(P = 0.079), abductor weakness (IV level)occurred in two patients in the C-shaped release group and five cases in the conventional release group (P = 0.208). GDS was 49.3 ± 17.3 (22 to 70) in theC-shaped release group and 48.1 ± 15.6 (23 to 69) in the conventional release group before surgery (P = 0.622), 91.7 ± 5.2 (83 to 100) in the C-shaped release group and 90.2 ± 6.1 (83 to 98) in the conventional release group (P = 0.073) with difference nearly significant at last follow-up.


CONCLUSION
Arthroscopic C-shaped release around the greater trochanter had less operation time, acceptable complication occurrence, and it has an optimistic outcome for gluteal muscle contracture under arthroscope.
['Tang|Xiangyu|X|', 'Qi|Wei|W|', 'Liu|Yujie|Y|', 'Xiang|Yi|Y|', 'Zhang|Baiqing|B|https://orcid.org/0000-0001-8561-0198', 'Li|Haipeng|H|https://orcid.org/0000-0003-0620-6360', 'Li|Zhongli|Z|', 'Wang|Zhigang|Z|', 'Wang|Dong|D|', 'Li|Chunbao|C|https://orcid.org/0000-0001-6979-2526']
D000328:Adult D001182:Arthroscopy D002081:Buttocks D003286:Contracture D004185:Disability Evaluation D005260:Female D006801:Humans D008297:Male D018482:Muscle, Skeletal D010147:Pain Measurement D055815:Young Adult
Gluteal muscle contracture Arthroscopy Disability