Surgical Reconstruction of Irreparable Hip Abductors With the Use of Allograft: A Systematic Review and Meta-analysis of Clinical Outcomes.
Sean C Clark, Seungjun Lee, Terence L Thomas et al.
✦ AI-curated · Sources linked
In 30 seconds
This systematic review and meta-analysis assessed clinical outcomes, complications, and revisions after allograft reconstruction for irreparable hip abductor tears. Five studies included 76 patients (76 hips), predominantly women, with a mean follow-up of 23.6 months. Patient-reported outcomes improved in all four studies reporting preoperative and postoperative measures. Mean abduction strength increased from 2.7/5 before surgery to 3.9/5 afterward (P < 0.001). Complications occurred in 5.3% (4/76) and revision in 1.3% (1/76); some patients continued to have a Trendelenburg sign.
Key findings
- Mean abduction strength improved from 2.7/5 preoperatively to 3.9/5 postoperatively (P < 0.001).
- All four studies reporting patient-reported outcomes found improvement after reconstruction.
- The complication rate was 5.3% (4/76), and the revision rate was 1.3% (1/76).
- Two studies reported a persistent postoperative Trendelenburg sign in more than one third of patients.
Why it matters
Chronic hip abductor insufficiency can cause substantial disability, and primary repair may not be feasible in irreparable tears. These pooled findings suggest allograft reconstruction can improve reported outcomes and abduction strength, while also showing that functional signs may persist. The results help characterize this salvage option but do not establish its comparative effectiveness against other reconstructive approaches.
What to keep in mind
The review included only five studies and 76 patients, with a mean follow-up of 23.6 months. The evidence does not compare allograft reconstruction directly with other muscle transfer techniques.