Initial results of using pedicle vastus lateralis muscle flap in treatment of persistent hip infections after arthroplasties

  • Phùng Văn Tuấn Bệnh viện Trung ương Quân đội 108
  • Lê Văn Đoàn Bệnh viện Trung ương Quân đội 108
  • Lê Hồng Hải Bệnh viện Trung ương Quân đội 108
  • Nguyễn Quốc Dũng Bệnh viện Trung ương Quân đội 108
  • Ngô Thái Hưng Bệnh viện Trung ương Quân đội 108
  • Mai Đắc Việt Bệnh viện Trung ương Quân đội 108
  • Nguyễn Tiến Thành Bệnh viện Trung ương Quân đội 108

Main Article Content

Keywords

Hip infections after arthroplasties, pedicle vastus lateralis muscle flap

Abstract

Objective: To evaluate initial results of using pedicle vastus lateralis muscle flap in treatment of persistent hip infections after arthroplasties. Indications and techniques were then discussed. Subject and method:  Three cases whom suffered from persistent hip infections after arthroplasties for 3 months to 5 years, underwent 7 to 28 times of operations using two semi-island flaps and one island flap. Result: Postoperative follow-up time were from 3 - 4 months (3.3 months in average). All patients were completely healed at operative site, no pain or only mild pain at the hip (VAS 1 - 2). Quadriceps muscle strength and ROM of knees were maintained as compared to pre-muscles transfer. Conclusion: Using pedicle vastus lateralis muscle flap in treatment of persistent hip infections after arthroplasties showed promising outcome, resuted in eradication of infection, pain relief and maintenance of knees function.

Article Details

References

1. Arnold PG, Wilzke DJ (1983) Management of failed total hip arthroplasty with muscle flaps. Ann Plast Surg. Dec 11(6): 474-478.
2. Choa R, Gundle R, Critchley P, Giele H (2011) Successful management of recalcitrant infection related to total hip replacement using pedicled rectus femoris or vastus lateralis muscle flaps. J Bone Joint Surg [Br] 93-B: 751-754.
3. Collins DN, Garvin KL, Nelson GL (1987) The use of the vastus lateralis flap in patients with intractable infection after resection arthro - plasty following the use of a hip implant. J Bone Joint Surg Am 69: 510.
4. Francesca T, Salvatore D, Erich B, Carlo M, Francesco M, Adriana C (2015) Segmental anatomy of the vastus lateralis: Guidelines for muscle-sparing flap harvest. Plastic and Reconstructive Surgery 35: 185-198.
5. Meland NB, Arnold PG, Weiss HC (1991) Management of the recalcitrant total-hip arthroplasty wound. Plast Reconstr Surg 88: 681.
6. Rodríguez RG, Cebrián JL, Francés BA, Marco MF, López DL (2012) Treatment of a recalcitrant hip infection with a vastus lateralis muscle flap. Rev Esp Cir Ortop Traumatol 56(6): 439-443.
7. Salibian AH, Anzel SH, Rogers FR (1984) The gluteus medius-tensor fasciae latae myo - cutaneous flap for infected girdlestone procedures: Report of two cases. J Bone Joint Surg [Am] 66-A: 1466-1468.
8. Suda AJ, Heppert V (2010) Vastus lateralis muscle flap for infected hips after resection arthroplasty. J Bone Joint Surg [Br] 92-B: 1654-1658.
9. Tayfur V, Magden O, Ediser M, Atabey A (2010) Anatomy of vastus lateralis muscle flap. J craniofac Surg 21(6): 1951-1953.
10. Tohtz S (2007) Girdlestone arthroplasty after hip prosthesis infection - a two-stage revision. Infection and Local Treatment in Orthopedic Surgery, Springer-Verlag Berlin Heidelberg: 189-193.
11. Wolff KD, Hölzle F (2005) Anterolateral thigh/ vastus lateralis flap. Raising of microvascular flaps, a systematic approach. Springer Verlag Berlin Heidelberg: 39-64.