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Botulinum toxin type A injections for the management of muscle tightness following total hip arthroplasty: a case series

BACKGROUND: Development of hip adductor, tensor fascia lata, and rectus femoris muscle contractures following total hip arthroplasties are quite common, with some patients failing to improve despite treatment with a variety of non-operative modalities. The purpose of the present study was to describ...

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Autores principales: Bhave, Anil, Zywiel, Michael G, Ulrich, Slif D, McGrath, Mike S, Seyler, Thorsten M, Marker, David R, Delanois, Ronald E, Mont, Michael A
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2743655/
https://www.ncbi.nlm.nih.gov/pubmed/19709429
http://dx.doi.org/10.1186/1749-799X-4-34
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author Bhave, Anil
Zywiel, Michael G
Ulrich, Slif D
McGrath, Mike S
Seyler, Thorsten M
Marker, David R
Delanois, Ronald E
Mont, Michael A
author_facet Bhave, Anil
Zywiel, Michael G
Ulrich, Slif D
McGrath, Mike S
Seyler, Thorsten M
Marker, David R
Delanois, Ronald E
Mont, Michael A
author_sort Bhave, Anil
collection PubMed
description BACKGROUND: Development of hip adductor, tensor fascia lata, and rectus femoris muscle contractures following total hip arthroplasties are quite common, with some patients failing to improve despite treatment with a variety of non-operative modalities. The purpose of the present study was to describe the use of and patient outcomes of botulinum toxin injections as an adjunctive treatment for muscle tightness following total hip arthroplasty. METHODS: Ten patients (14 hips) who had hip adductor, abductor, and/or flexor muscle contractures following total arthroplasty and had been refractory to physical therapeutic efforts were treated with injection of botulinum toxin A. Eight limbs received injections into the adductor muscle, 8 limbs received injections into the tensor fascia lata muscle, and 2 limbs received injection into the rectus femoris muscle, followed by intensive physical therapy for 6 weeks. RESULTS: At a mean final follow-up of 20 months, all 14 hips had increased range in the affected arc of motion, with a mean improvement of 23 degrees (range, 10 to 45 degrees). Additionally all hips had an improvement in hip scores, with a significant increase in mean score from 74 points (range, 57 to 91 points) prior to injection to a mean of 96 points (range, 93 to 98) at final follow-up. There were no serious treatment-related adverse events. CONCLUSION: Botulinum toxin A injections combined with intensive physical therapy may be considered as a potential treatment modality, especially in difficult cases of muscle tightness that are refractory to standard therapy.
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spelling pubmed-27436552009-09-15 Botulinum toxin type A injections for the management of muscle tightness following total hip arthroplasty: a case series Bhave, Anil Zywiel, Michael G Ulrich, Slif D McGrath, Mike S Seyler, Thorsten M Marker, David R Delanois, Ronald E Mont, Michael A J Orthop Surg Res Research Article BACKGROUND: Development of hip adductor, tensor fascia lata, and rectus femoris muscle contractures following total hip arthroplasties are quite common, with some patients failing to improve despite treatment with a variety of non-operative modalities. The purpose of the present study was to describe the use of and patient outcomes of botulinum toxin injections as an adjunctive treatment for muscle tightness following total hip arthroplasty. METHODS: Ten patients (14 hips) who had hip adductor, abductor, and/or flexor muscle contractures following total arthroplasty and had been refractory to physical therapeutic efforts were treated with injection of botulinum toxin A. Eight limbs received injections into the adductor muscle, 8 limbs received injections into the tensor fascia lata muscle, and 2 limbs received injection into the rectus femoris muscle, followed by intensive physical therapy for 6 weeks. RESULTS: At a mean final follow-up of 20 months, all 14 hips had increased range in the affected arc of motion, with a mean improvement of 23 degrees (range, 10 to 45 degrees). Additionally all hips had an improvement in hip scores, with a significant increase in mean score from 74 points (range, 57 to 91 points) prior to injection to a mean of 96 points (range, 93 to 98) at final follow-up. There were no serious treatment-related adverse events. CONCLUSION: Botulinum toxin A injections combined with intensive physical therapy may be considered as a potential treatment modality, especially in difficult cases of muscle tightness that are refractory to standard therapy. BioMed Central 2009-08-26 /pmc/articles/PMC2743655/ /pubmed/19709429 http://dx.doi.org/10.1186/1749-799X-4-34 Text en Copyright © 2009 Bhave et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Bhave, Anil
Zywiel, Michael G
Ulrich, Slif D
McGrath, Mike S
Seyler, Thorsten M
Marker, David R
Delanois, Ronald E
Mont, Michael A
Botulinum toxin type A injections for the management of muscle tightness following total hip arthroplasty: a case series
title Botulinum toxin type A injections for the management of muscle tightness following total hip arthroplasty: a case series
title_full Botulinum toxin type A injections for the management of muscle tightness following total hip arthroplasty: a case series
title_fullStr Botulinum toxin type A injections for the management of muscle tightness following total hip arthroplasty: a case series
title_full_unstemmed Botulinum toxin type A injections for the management of muscle tightness following total hip arthroplasty: a case series
title_short Botulinum toxin type A injections for the management of muscle tightness following total hip arthroplasty: a case series
title_sort botulinum toxin type a injections for the management of muscle tightness following total hip arthroplasty: a case series
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2743655/
https://www.ncbi.nlm.nih.gov/pubmed/19709429
http://dx.doi.org/10.1186/1749-799X-4-34
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