scholarly journals Combined Transfer of the Gluteus Maximus and Tensor Fasciae Latae for Irreparable Gluteus Medius Tear Using Contemporary Techniques

2020 ◽  
Vol 5 (4) ◽  
pp. e00040-e00040
Author(s):  
David R. Maldonado ◽  
Shawn Annin ◽  
Jeffrey W. Chen ◽  
Mitchell J. Yelton ◽  
Jacob Shapira ◽  
...  
Keyword(s):  
Gluteus Maximus ◽  
Gluteus Medius ◽  
Tensor Fasciae Latae

Effect of side-sling plank exercise on trunk and hip muscle activation in subjects with gluteus medius weakness

2021 ◽  
pp. 1-9
Author(s):  
Seung-Min Baik ◽  
Heon-Seock Cynn ◽  
Chung-Hwi Yi ◽  
Ji-Hyun Lee ◽  
Jung-Hoon Choi ◽  
...  
Keyword(s):  
Muscle Activation ◽  
Gluteus Maximus ◽  
Gluteus Medius ◽  
Erector Spinae ◽  
Lumbar Multifidus ◽  
Hip Muscle ◽  
Hip Abduction ◽  
Medial Rotation ◽  
Hip Muscles ◽  
Tensor Fasciae Latae

BACKGROUND: The effectiveness of side-sling plank (SSP) exercises on trunk and hip muscle activation in subjects with gluteus medius (Gmed) weakness is unclear. OBJECTIVE: To quantify muscle activation of the rectus abdominis (RA), external oblique (EO), erector spinae (ES), lumbar multifidus (LM), Gmed, gluteus maximus (Gmax), and tensor fasciae latae (TFL) during SSP with three different hip rotations compared to side-lying hip abduction (SHA) exercise in subjects with Gmed weakness. METHODS: Twenty-two subjects with Gmed weakness were recruited. SHA and three types of SSP exercises were performed: SSP with neutral hip (SSP-N), hip lateral rotation (SSP-L), and hip medial rotation (SSP-M). Surface electromyography was used to measure the activation of the trunk and hip muscles. RESULTS: The trunk and hip muscles activations were generally significantly higher level during three SSP than SHA. SSP-M showed significantly lower EO activation while significantly higher ES and LM activation than SSP-L. Gmed activation was significantly higher during SSP-M than during SSP-L. TFL activation was significantly lower during SSP-M than during SSP-N and SSP-L. CONCLUSIONS: SSP could be prescribed for patients who have reduced Gmed strength after injuries. Especially, SSP-M could be applied for patients who have Gmed weakness with dominant TFL.

Relationship between muscular and bony anatomy in native hips: a theoretical background for approach-specific implant positioning

2018 ◽  
Vol 29 (2) ◽  
pp. 147-152 ◽  
Author(s):  
Doruk Akgün ◽  
Philipp von Roth ◽  
Tobias Winkler ◽  
Carsten Perka ◽  
Adam Trepczynski ◽  
...  
Keyword(s):  
Gluteus Maximus ◽  
Gluteus Medius ◽  
Theoretical Background ◽  
Surgical Approaches ◽  
Acetabular Anteversion ◽  
Joint Orientation ◽  
Combined Anteversion ◽  
Bony Anatomy ◽  
The Mean ◽  
Tensor Fasciae Latae

Introduction: The aim of this study was to analyse the relationship between bony joint orientation and the distribution of hip musculature. Methods: The bone anatomy of the hip (femoral antetorsion (AT), acetabular anteversion (AV), and combined anteversion (AV/AT)) and the muscle volume of the gluteal muscles and the tensor fasciae latae were analysed bilaterally using computed tomography data of 49 patients. Muscle force direction (MFD) was determined for each muscle. The total MFD of the hip musculature was calculated and then correlated with the bony anatomy. Results: The mean AV, AT, and AV/AT were 21.9° ± 5.9°, 7.22° ± 7.4°, and 29.2° ± 9°, respectively. We found the following mean muscle volumes: gluteus maximus: 780 ± 227 cm3, gluteus medius: 322 ± 82 cm3, gluteus minimus: 85 ± 20 cm3, and tensor fasciae latae: 68 ± 22 cm3. The mean MFD was 18.92° ± 1.29°. We found a uniform distribution of the musculature that was not correlated with the bone anatomy. Conclusion: This study highlights the variability in native acetabular and femoral anatomy and that bone hip anatomy does not correlate with the distribution of hip musculature. Although native acetabular anteversion matches the suggested targets for cup insertion, native combined anteversion is not related to current implant insertion targets. Understanding native muscular anatomy and the alterations that occur with different surgical approaches can serve as an explanatory model for THAs that has become unstable despite the components being implanted within the safe zone.

Perikoxale Schmerzsyndrome – nicht immer einfach zu diagnostizieren

2016 ◽  
Vol 36 (01) ◽  
pp. 9-14
Author(s):  
T. Guttke ◽  
I. Arnold
Keyword(s):  
Gluteus Maximus ◽  
Gluteus Medius ◽  
Anterior Inferior Iliac Spine ◽  
Tractus Iliotibialis ◽  
Tensor Fasciae Latae ◽  
Nervus Ischiadicus

ZusammenfassungPertrochantäre Schmerzen stellen ein häufiges klinisches Problem dar. Auch wenn perikoxale Schmerzsyndrome bereits früh beschrieben worden sind, hat die Weiterent-wicklung der arthroskopischen Techniken unter Einbezug der extrakapsulären Kompartimente die Sensibilität für diese häufig fehl -interpretierten Erkrankungsformen erhöht. Voos und Mitarbeiter veröffentlichten 2007 sehr früh ihre ersten Ergebnisse im Hinblick auf endoskopische Interventionen in diesem Zusammenhang (1). Andere Erkrankungsformen wie das “low anterior inferior iliac spine impingement” wurden sogar erst durch die Hüftarthroskopie der Beschreibung zugänglich. Zu den pertrochantären Pathologien, die das laterale Kompartiment betreffen, zählen Bursitiden und Insertionstendinosen der Glutealmuskulatur bis hin zur Ruptur und das Tractus-iliotibialis-Syndrom einschließlich der externen Schnapphüfte. Projektionsschmerzen von der proximalen Lendenwirbelsäule sind in dieser Übersicht nicht berücksichtigt, verursachen aber in bis zu 30 % pertrochantäre Beschwerden. Auf nervaler Ebene können Irritationen des inferioren Glutealnervs mit radikulärem Ursprung L5–S2 (Innervation des M. gluteus maximus) oder des N. gluteus superior (Wurzeln L4–S1; Innervation des M. gluteus medius und minimus, M. tensor fasciae latae und vordere Partien des Hüft gelenks) Trochanter-bezogene Schmerzen imitieren. Im ventralen extraartikulären Kompartiment kann eine Friktion der Sehne des M. iliopsoas ein internes Impingement und Schnappen verant-worten. Natürlich sind differenzialdiagnostisch auch Arthrose-assoziierte muskulotendinöse Kontrakturen oder auch Gangasymmetrien bzw. Störungen im lumbosakralen Übergang mit konsekutiven muskulären Dysbalancen auszuschließen. Aber auch nach Hüftgelenkersatz stellen unzureichend azetabulär-knöchern gedeckte Pfannenkomponenten eine Disposition für eine Irritation der Hüftbeuger dar. Anatomisch dem posterioren Bereich zugeordnet sind die Strukturen um den Nervus ischiadicus (z. B. Entrapmentphänomene durch fibrinöse Stränge), die Hüftaußenrotatoren und explizit der M. piriformis. Aber auch Insertionstendinopathien der Hamstrings sind differenzialdiagnostisch perikoxalen Schmerzsyndromen zuzuordnen.

scholarly journals Evaluation of muscle volume and degeneration after total hip arthroplasty: a comparison of the posterolateral approach and the anterolateral supine approach

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Taku Ukai ◽  
Goro Ebihara ◽  
Haruka Omura ◽  
Masahiko Watanabe
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Gluteus Maximus ◽  
Gluteus Medius ◽  
Muscle Volume ◽  
Posterolateral Approach ◽  
Hounsfield Units ◽  
Total Hip ◽  
Internal Obturator Muscle ◽  
Tensor Fasciae Latae

Abstract Background Muscle strength around the hip after total hip arthroplasty (THA) is crucial for preventing dislocation and limping. This study aimed to assess and compare muscle volume and degeneration after THA using the posterolateral (PL) and anterolateral (AL) approaches. Methods Sixty-four hips in 64 patients who underwent primary THA were retrospectively analyzed. Patients were segregated into the PL group (35 hips) and AL group (29 hips) for evaluating pre- and postoperative muscle volumes and degeneration around the hip. Computed tomography (CT) examinations were performed preoperatively and 6 months post THA. The muscle volume and Hounsfield units (HU) of the gluteus maximus (G-max), gluteus medius (G-med), tensor fasciae latae, internal obturator muscle, and external obturator muscle were measured. Results In the PL group, the postoperative muscle volume of the G-max significantly increased than the preoperative muscle volume. In contrast, the postoperative muscle volume of the internal obturator muscle was significantly lower than the preoperative muscle volume. The postoperative HU of the internal and external obturator muscles were significantly lower than the preoperative HU. In the AL group, the postoperative muscle volumes of the G-max, G-med, and tensor fasciae latae significantly increased than their preoperative muscle volumes. The postoperative HU of the G-med and tensor fasciae latae were significantly higher than the preoperative HU values. Conclusion The PL approach can lead to degeneration of the internal and external obturator. The AL approach is more beneficial for recovering the G-med, tensor fasciae latae, and internal obturator muscle than the PL approach.

scholarly journals Effects of Log Rolling Position on Hip Abductor Muscles Activity During Side-Lying Hip Abduction Exercise in Participants with Gluteus Medius Weakness

2020 ◽  
Author(s):  
Seung-min Baik ◽  
Heon-seock Cynn ◽  
Jae-hun Shim ◽  
Ji-hyun Lee ◽  
A-reum Shin ◽  
...  
Keyword(s):  
Analysis Of Variance ◽  
Repeated Measures ◽  
Statistical Significance ◽  
Frontal Plane ◽  
Gluteus Maximus ◽  
Gluteus Medius ◽  
Neutral Position ◽  
Hip Abduction ◽  
Hip Abductor ◽  
Tensor Fasciae Latae

Abstract Context: Weakness of the gluteus medius and the gluteus maximus is associated with a variety of musculoskeletal disorders. However, activation of synergist muscles that are not targeted should be considered when prescribing side-lying hip abduction (SHA) exercises. Log-rolling positions may affect hip abductors activity during SHA. Objectives: To determine the effects of log-rolling positions on the gluteus medius, the gluteus maximus, and the tensor fasciae latae activity during SHA in participants with gluteus medius weakness. Design: The effects of different log-rolling positions on hip abductor activity during SHA were analyzed by one-way repeated-measures analysis of variance. Setting: University research laboratory. Participants: Twenty-one participants with gluteus medius weakness were recruited. Interventions: Three types of SHA were performed: SHA in the frontal plane with a neutral position (SHA-neutral), SHA in the frontal plane with an anterior log-rolling position (SHA-anterior rolling), and SHA in the frontal plane with a posterior log-rolling position (SHA-posterior rolling). Main Outcome Measures: Surface electromyography was used to measure the hip abductor activity. One-way repeated-measure analysis of variance was used to assess the statistical significance of the muscle activity. Results: SHA-anterior rolling showed significantly greater gluteus medius and gluteus maximus activation than SHA-neutral (P = .003 and P < .001, respectively) and SHA-posterior rolling (P < .001 and P < .001, respectively). SHA-neutral showed significantly greater gluteus medius and gluteus maximus activation than SHA-posterior rolling (P < .001 and P = .001, respectively). SHA-anterior rolling showed significantly less tensor fasciae latae activation than SHA-neutral (P < .001) and SHA-posterior rolling (P < .001). SHA-neutral showed significantly less tensor fasciae latae activation than SHA-posterior rolling (P < .001). Conclusion: SHA-anterior rolling may be an effective exercise to increase activation of the gluteus medius and the gluteus maximus while decreasing the tensor fasciae latae in participants with gluteus medius weakness.

scholarly journals Effects of rehabilitation and arthroplasty on the hip isometric muscle strength in patients with osteoarthritis of the hip

2009 ◽  
Vol 62 (5-6) ◽  
pp. 236-240 ◽  
Author(s):  
Slavica Jandric
Keyword(s):  
Muscle Strength ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Gluteus Medius ◽  
Treated Group ◽  
Early Rehabilitation ◽  
Control Group ◽  
Osteoarthritis Of The Hip ◽  
Total Hip ◽  
Tensor Fasciae Latae

Introduction Periarticular muscles have a significant role in keeping the mobility and integrity of the hip joint. The aim of this article was to investigate the effects of the total hip arthroplasty and early rehabilitation on the muscle strength. Patients Three groups of examined persons (matched in relation to musculosceletal conditions, sex, age and occupation) were included in the investigation. The first group (40 of the involved hip) and the second group (with 33 involved hips) were groups of patients with late-stage of osteoarthritis of the hip. The first group of patients was managed conservatively and the second group operatively (total cemented hip endoprosthesis was performed). The third group was control group with 123 healthy hips. Material and methods The maximal voluntary isometric strength was measured with dynamometer. The muscle strength was tested in all three groups: in the first group of patients at the beginning and at the end of the therapy and in patients of the second group 6?3 months postoperatively. Results A significant improvement of the muscle strength was noted for the flexors (t=2.45, p<0.05), musculus tensor fasciae latae (t=2.35, p<0.05), extensors (t=2.85, p<0.01), adductors (t=3.02, p<0.01), external rotators (t=3.1, p<0.01), m. gluteus medius (t=5.28, p<0.001) and internal rotators (t=5.77, p<0.001) after total hip arthroplasty and early rehabilitation in comparison to the conservatively treated group. Conclusion The muscle strength in the patients with osteoarthritis of the hip after arthroplasty was significantly higher than after rehabilitation for all hip muscles but did not reach values of the strength of the muscles in the corresponding control group.

Muscle Function and Coordination of Stair Ascent

2017 ◽  
Vol 140 (1) ◽  
Author(s):  
Nicole G. Harper ◽  
Jason M. Wilken ◽  
Richard R. Neptune
Keyword(s):  
Three Dimensional ◽  
Gluteus Maximus ◽  
Gluteus Medius ◽  
Patient Specific ◽  
Functional Roles ◽  
Stair Ascent ◽  
Lower Limb Muscles ◽  
Ankle Joints ◽  
Community Environments ◽  
Antagonistic Muscles

Stair ascent is an activity of daily living and necessary for maintaining independence in community environments. One challenge to improving an individual's ability to ascend stairs is a limited understanding of how lower-limb muscles work in synergy to perform stair ascent. Through dynamic coupling, muscles can perform multiple functions and require contributions from other muscles to perform a task successfully. The purpose of this study was to identify the functional roles of individual muscles during stair ascent and the mechanisms by which muscles work together to perform specific subtasks. A three-dimensional (3D) muscle-actuated simulation of stair ascent was generated to identify individual muscle contributions to the biomechanical subtasks of vertical propulsion, anteroposterior (AP) braking and propulsion, mediolateral control and leg swing. The vasti and plantarflexors were the primary contributors to vertical propulsion during the first and second halves of stance, respectively, while gluteus maximus and hamstrings were the primary contributors to forward propulsion during the first and second halves of stance, respectively. The anterior and posterior components of gluteus medius were the primary contributors to medial control, while vasti and hamstrings were the primary contributors to lateral control during the first and second halves of stance, respectively. To control leg swing, antagonistic muscles spanning the hip, knee, and ankle joints distributed power from the leg to the remaining body segments. These results compliment previous studies analyzing stair ascent and provide further rationale for developing targeted rehabilitation strategies to address patient-specific deficits in stair ascent.

Hip and Trunk Muscle Activity During the Star Excursion Balance Test in Healthy Adults

2019 ◽  
Vol 28 (7) ◽  
pp. 682-691 ◽  
Author(s):  
Kunal Bhanot ◽  
Navpreet Kaur ◽  
Lori Thein Brody ◽  
Jennifer Bridges ◽  
David C. Berry ◽  
...  
Keyword(s):  
Dynamic Balance ◽  
Gluteus Maximus ◽  
Gluteus Medius ◽  
Healthy Adults ◽  
Rectus Abdominis ◽  
Erector Spinae ◽  
Trunk Muscles ◽  
Electromyographic Activity ◽  
Balance Test ◽  
External Oblique

Context:Dynamic balance is a measure of core stability. Deficits in the dynamic balance have been related to injuries in the athletic populations. The Star Excursion Balance Test (SEBT) is suggested to measure and improve dynamic balance when used as a rehabilitative tool.Objective:To determine the electromyographic activity of the hip and the trunk muscles during the SEBT.Design:Descriptive.Setting:University campus.Participants:Twenty-two healthy adults (11 males and 11 females; 23.3 [3.8] y, 170.3 [7.6] cm, 67.8 [10.3] kg, and 15.1% [5.0%] body fat).Intervention:Surface electromyographic data were collected on 22 healthy adults of the erector spinae, external oblique, and rectus abdominis bilaterally, and gluteus medius and gluteus maximus muscle of the stance leg. A 2-way repeated measures analysis of variance was used to determine the interaction between the percentage maximal voluntary isometric contraction (%MVIC) and the reach directions. The %MVIC for each muscle was compared across the 8 reach directions using the Sidak post hoc test withαat .05.Main Outcome Measures:%MVIC.Results:Significant differences were observed for all the 8 muscles. Highest electromyographic activity was found for the tested muscles in the following reach directions—ipsilateral external oblique (44.5% [38.4%]): anterolateral; contralateral external oblique (52.3% [40.8%]): medial; ipsilateral rectus abdominis (8% [6.6%]): anterior; contralateral rectus abdominis (8% [5.3%]): anteromedial; ipsilateral erector spinae (46.4% [20.2%]): posterolateral; contralateral erector spinae (33.5% [11.3%]): posteromedial; gluteus maximus (27.4% [11.7%]): posterior; and gluteus medius (54.6% [26.1%]): medial direction.Conclusions:Trunk and hip muscle activation was direction dependent during the SEBT. This information can be used during rehabilitation of the hip and the trunk muscles.

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