FUNCTION OF REINSERTED ABDUCTOR MUSCLES AFTER FEMORAL REPLACEMENT

We compared two methods of reconstruction of the abductor mechanism in 15 patients after prosthetic replacement of the upper femur, to asses s abductor strength and function. Six patients in group I had direct f ixation of the gluteus medius tendon and a segment of the original bon e to the prosthesis. Nine patients in group 2 had the abductor tendon fixed to the iliotibial band. We assessed clinical function, isometric muscle strength and muscle cross-sectional area for each patient.The patients in group 1 had better clinical and functional results (p = 0. 059), with average peak torques for hip abduction of 92% of that in th e non-operated leg in group 1, and of 57% in group 2. Group 1 had a me an muscle cross-sectional area of 69% and a mean value of strength per cross-sectional area of 134% when compared with the control side. The respective values for group 2 were 52% and 91%. Direct fixation of th e abductor muscles to the prostheses gave improved function and higher isometric abductor muscle force.