Board-certified Orthopaedic Surgeon, Section Chief – Joint Reconstructive Surgery

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Dr. Incavo was an Invited Presenter at the 2021 AAHKS Annual Meeting

Dr. Incavo and colleagues were invited to present their latest research findings, Kinematic Gait Analysis with Motion Capture Technology Following Total Knee Arthroplasty,  Clinical Outcomes for Open Hip Abductors Repair Using Tenodesis and Bone Trough Repair Technique and Intraosseous Morphine Decreases Postoperative Pain in Total Knee Arthroplasty at the 2021 American Association of Hip and Knee Surgeons (AAHKS) Annual Meeting recently held in Dallas, TX.

Dr. Incavo and colleagues were invited to present their latest research findings, Kinematic Gait Analysis with Motion Capture Technology Following Total Knee Arthroplasty,  Clinical Outcomes for Open Hip Abductors Repair Using Tenodesis and Bone Trough Repair Technique and Intraosseous Morphine Decreases Postoperative Pain in Total Knee Arthroplasty at the 2021 American Association of Hip and Knee Surgeons (AAHKS) Annual Meeting recently held in Dallas, TX.

Abstract – Clinical Outcomes for Open Hip Abductors Repair Using Tenodesis and Bone Trough Repair Technique

Author(s):  Kwan J Park, MD; Manuel Rodriguez-Perez, MD; Thomas C. Sullivan, BS; Bradley S Lambert, PHD; Brian Gilcrease-garcia, MD; Stephen J. Incavo, MD;


Introduction: Hip abductor tear can lead to chronic pain, weakness, and gait abnormalities. We report patients who had abductor tendon repair. Surgical treatment was based on the status of gluteus medius muscle: No detachment (type I) or avulsion (type II) from the greater trochanter. Methods: Type I tears were treated with tenodesis of the gluteus medius and minimus. Type II tears were treated with gluteus medius advancement into a bone trough in the greater trochanter. No patient had a combined abductor repair/THR. Pain (VAS), gait (normal/antalgic), muscle strength (0-5), MRI, and patient questionnaires were evaluated. Results: 45 hips (44 patients) had a minimum of 6 months follow-up (6-76 months). There were 27 Type I and 18 Type II tears. 87% of patients were female. 28% of type II patients (5/18) had a prior arthroplasty. Pain scores improved from 7.9 ± 0.5 to 2.1 ± 0.6 (p<0.001): 7.8 ± 0.6 to 1.9 ± 0.5 (p<0.001) in type I, and 7.9 ± 0.9 to 2.4 ± 1.2 type II (p<0.001). 9% had normal preoperative gait (11% type 1 and 6% type II) and at post-op 67% normal gait (p<0.001). Gait normalized in 81% type I (p<0.001) and 56% in type II patients (p<0.007) with no difference between groups despite a statistical trend (p=0.06). Muscle strength improved from 3.9 ± 0.3 to 4.6 ± 0.2 (p<0.001) overall. Postoperative MR imaging at 6-months was performed in 21 of the type I hips and 10 of the type II hips. For type I, MRI showed healed tenodesis in 17/21 hips, and, for type II, MRI showed healed bone trough repair in 5/10 type II hips. Conclusion: Abductor repair improved patient pain, and Type I tears had superior outcomes. MRI suggested successful repair in 81% of type I tears, and approximately 50% of type II tears.

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