Evaluating hip disarticulation outcomes in a 51-patient series

Allison Huffman; Steven Schneeberger; Evelyn Goodyear; Julie M West; Andrew L O'Brien; Thomas J Scharschmidt; Joel L Mayerson; Steven A Schulz; Amy M Moore

doi:10.1016/j.jor.2022.04.008

Evaluating hip disarticulation outcomes in a 51-patient series

J Orthop. 2022 Apr 19:31:117-120. doi: 10.1016/j.jor.2022.04.008. eCollection 2022 May-Jun.

Authors

Allison Huffman¹, Steven Schneeberger¹, Evelyn Goodyear¹, Julie M West¹, Andrew L O'Brien¹, Thomas J Scharschmidt², Joel L Mayerson², Steven A Schulz³, Amy M Moore¹

Affiliations

¹ Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
² Department of Orthopaedic Surgery, The Ohio State University James Wexner Medical Center, Columbus, OH, USA.
³ Vanguard Aesthetic Plastic Surgery, Fort Lauderdale, Florida, USA.

Abstract

Background: Hip disarticulations are proximal lower extremity amputations with high postoperative complication and mortality rates. The purpose of the study was to evaluate hip disarticulation outcomes at our institution. Targeted Muscle Reinnervation (TMR) is an effective surgical technique shown to reduce pain in amputees. A secondary goal of the study was to evaluate the impact of implementing TMR on this patient population.

Methods: A retrospective review was performed for patients who underwent hip disarticulation with and without TMR between 2009 and 2020. Information on one-year mortality, thirty-day complication rates, operation times, surgical charges, and pain scores was collected.

Results: Fifty-one patients underwent hip disarticulation, eight of which had TMR performed at the time of their hip disarticulation. The one-year mortality rate was 37% with 30-day infection, readmission, reoperation, and rates of 37%, 39%, and 27% respectively. The thirty-day major complication rate was 47% overall but not statistically significantly different between groups. There were no differences between groups with regard to 30-day readmission, reoperation, and infection rates.

Conclusions: Our results represent one of the largest series of hip disarticulation outcomes. Performing TMR at the time of hip disarticulation did not negatively affect outcomes and may be a beneficial adjunct to improve pain. Further research is warranted.

Keywords: Amputation; Hip disarticulation; Nerves; Targeted Muscle Reinnervation (TMR), transcutaneous electrical nerve stimulation (TENS); Targeted muscle reinnervation.