Advancement of the vastus lateralis muscle for the treatment of hip abductor discontinuity

Impaired abductor function of the hip resulting from a discontinuous gluteus medius often is encountered in revision hip surgery. If the gluteus medius can be reattached to the proximal femur, functional results are satisfactory. If this is not possible, it would be desirable to restore the continuity of the gluteus medius by bridging the defect with local tissue. An anatomic study was performed in 15 cadavers, and proximal advancement of the vastus lateralis without injury to the neurovascular pedicle was 8 cm (range, 7–10 cm). Clinically, the technique was used in 3 patients. At follow-up, both living patients walked without a cane and both were able to hold the leg abducted against moderate pressure. Proximal advancement of the vastus lateralis can successfully bridge defects of the gluteus medius and partially restores abductor function.