Does tenodesis of tensor fascia latae with hip abductors after proximal femoral resection and modular endoprosthetic reconstruction lead to functional improvements?
Bibliographic record
Abstract
Purpose: Trendelenburg gait is a common consequence of proximal femoral oncologic resection. To mitigate limping, tensor fascia latae (TFL) tenodesis is employed by suturing the muscle to the abductor mechanism, repaired to the trochanteric portion of the endoprosthesis. Objective functional evaluation of this technique has not been conducted. This study aimed to determine (1) whether the procedure induces tensor fascia latae hypertrophy, (2) its impact on functional outcomes and (3) its effect on gait patterns. Methods: Sixteen patients who underwent proximal femoral resection and modular endoprosthesis reconstruction were assessed via computed tomography scans at least 1 year post-operatively for TFL and hip abductor hypertrophy and fatty infiltration. Patients were separated into two groups based on the presence or absence of TFL hypertrophy. Patient-related outcomes were evaluated with questionnaires, and a subset of seven patients underwent hip abductor strength measurement and gait analysis to assess objective function. Gait analysis included kinematics as well as electromyography. Results: At 1 year, half of the cohort demonstrated TFL hypertrophy. A trend towards improved functional scores was observed in the hypertrophy group. Hip kinematics indicated a greater adduction (max of 7.2 ± 4.1° vs. 2.8 ± 2.6°, 88% difference) in the hypertrophy group, resulting in an increased pelvic drop during single-limb support (5.2 ± 3.1° in the hypertrophy group and 3.4 ± 3.7° in the no hypertrophy group, 42% difference). Gluteus medius activation tended to be slightly greater during the stance phase for the no hypertrophy group, while the TFL was most activated in the hypertrophy group in the same period. Conclusion: The TFL tenodesis led to satisfactory functional outcomes for patients with proximal femoral reconstruction, whether they developed hypertrophy or not. TFL hypertrophy was not associated with a more favourable gait pattern, despite positive self-evaluated function. Level of Evidence: Level IV.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".