Abstract
BackgroundGluteal muscle contracture (GMC) is a notable problem in some developing countries and includes features such as a snapping sound of the hip, abnormal gait, and unusual posture when patients squat with the knees together. Arthroscopic release can not only resolve symptoms, as previously reported, but can also greatly improve accompanying patellofemoral instability. This study was conducted to evaluate the effect of arthroscopic release of GMC on patellofemoral instability and its underlying mechanism.MethodsA total of nearly 500 patients who underwent arthroscopic release of GMC over 2.5 years were filtered, and 54 patients were enrolled in the study. The selected research subjects all had combined patellofemoral instability preoperatively. The Lysholm scores and CT scans of the knee were evaluated pre- and postoperatively.ResultsThe mean follow-up time was 12.2 months. All of the surveyed patients had satisfactory clinical outcomes for hip snapping sounds and abnormal gait. In addition, a significant difference (p < 0.05) was observed between pre- and postoperative Lysholm scores, along with significant knee pain relief. Furthermore, the changes in CT scan parameters were significant as well. The average patellar tilt angle (PTA), patellofemoral index (PFI), and lateral patellar displacement (LPD) were obviously decreased (p < 0.05) after the release. Conversely, the mean lateral patellofemoral angle (LPFA) showed a clear difference (p < 0.05) between preoperative and postoperative CT examinations.ConclusionsArthroscopic release of GMC can reduce the tilt and lateral shift of the patella and enhance its stability due to the release of the iliotibial band.
Highlights
Gluteal muscle contracture (GMC) is a notable problem in some developing countries and includes features such as a snapping sound of the hip, abnormal gait, and unusual posture when patients squat with the knees together
Gluteal muscle contracture (GMC) is a disease that mainly occurs in adolescents and infants, and the majority of these patients receive repetitive buttock injections at very young ages [1]
Due to the contracture and fibrous degeneration of gluteal muscle, patients present with snapping sounds of the hip, an abnormal gait, and unusual posture when they squat with the knees
Summary
Gluteal muscle contracture (GMC) is a notable problem in some developing countries and includes features such as a snapping sound of the hip, abnormal gait, and unusual posture when patients squat with the knees together. Arthroscopic release can resolve symptoms, as previously reported, but can greatly improve accompanying patellofemoral instability. This study was conducted to evaluate the effect of arthroscopic release of GMC on patellofemoral instability and its underlying mechanism. Due to the contracture and fibrous degeneration of gluteal muscle, patients present with snapping sounds of the hip, an abnormal gait, and unusual posture when they squat with the knees. Concomitant symptoms, including pelvic tilts, lumbar muscle strain, and patellofemoral instability, can occur in patients with severe contractures and longer medical histories. Many patients suffer from knee pain, especially when crouching and walking up and down stairs, without any preceding trauma of the knee.
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