• A J Moussazadeh, H Kohlhof, D C Wirtz, M D Wimmer, T M Randau, T Wölk, and S Gravius.
• Department for Orthopaedic und Trauma Surgery, Alexianer Krankenhaus Krefeld GmbH-Krankenhaus Maria Hilf, Krefeld, Germany.
• Technol Health Care. 2013 Jan 1; 21 (5): 501-10.

BackgroundA lateral, transgluteal approach for hip resurfacing carries the risk of approach-related weakening of the hip abductors due to unsuccessful re-adaptation of the gluteal muscles to the greater trochanter or to injury to the inferior nerve branch of the superior gluteal nerve.ObjectiveWe investigated whether hip resurfacing using a soft tissue-sparing, modified transgluteal approach with limited cranial splitting of the gluteus medius muscle reduces hip abductor strength and the risk of approach-related injury to the superior gluteal nerve.MethodsThirty-one patients (14 female, 17 male; mean age 53.5 ± 5.2 years) underwent hip resurfacing using a modified transgluteal approach with limited cranial splitting of the gluteus medius muscle. Nerve conduction signals were measured by surface electromyography (EMG), hip abductor strength by isokinetic testing a mean 36.2 months (± 11 mos) after surgery. The unoperated side was used as control.ResultsSurface EMG disclosed no neural lesions of the inferior branch of the superior gluteal nerve. Isokinetics revealed a significant reduction in muscle strength on the operated versus the contralateral side.ConclusionsEven a limited incision of the gluteus medius muscle resulted in significant impairment of hip abductor strength 2.5 years after surgery.

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