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Introduction to the clinical stations
Published in Sukhpreet Singh Dubb, Core Surgical Training Interviews, 2020
Patients usually have hip pain, however, this may be referred to the groin or knee. Hip pain can often be bilateral and associated with reduced movements at the hip, particularly flexion. Upon examination, the patient may exhibit a Trendelenburg gait whereby on walking they lean toward the affected side. Active and passive flexion movements of the hip are likely to be limited and may also cause pain.
Femoral varus osteotomy in children
Published in K. Mohan Iyer, Hip Preservation Techniques, 2019
There are certain disadvantages with this procedure: There is potential to shorten the limb.Weakness of abductors.Trendelenburg gait.There is some difficulty in insertion of the femoral component in future arthroplasty.
Case 55: A Heavy Smoker with Proximal Weakness
Published in Layne Kerry, Janice Rymer, 100 Diagnostic Dilemmas in Clinical Medicine, 2017
The neurology team reviewed the patient and noted a mild Trendelenburg gait, signifying weakness of the lower limb abductor muscles. Electromyography was reported as characteristic for Lambert–Eaton myasthenic syndrome.
Gait synchronized neuromuscular electrical stimulation to the gluteus medius on a patient with right hemiparesis: a case report
Published in Physiotherapy Theory and Practice, 2022
Molly E. Warshaw, Mathew J. Baltz, John H. Hollman
A Trendelenburg gait pattern can be caused by a variety of diagnoses and can affect the gait efficiency and dynamic balance of a patient. It is typically associated with weak hip abduction muscle strength such as the gluteus medius. This leads to subsequent pelvic obliquity or pelvic drop during the stance phase of the affected side. To counteract this pelvic obliquity, patients will demonstrate a compensatory trunk lean to the ipsilateral side in order to maintain stability during gait (Krautwurst et al., 2013). An electromyography study showed statistically significant more synergistic hip flexion during maximal standing hip abduction strength testing in patients poststroke versus their age matched healthy counterparts (Neckel, Pelliccio, Nichols, and Hidler, 2006). Suggesting that while trying to use hip abduction musculature during gait, patients poststroke may be demonstrating more synergistic hip flexion instead of pure frontal plane motion needed to minimize Trendelenburg gait pattern, thereby decreasing the efficiency of their gait.
Gluteus medius tears of the hip: a comprehensive approach
Published in The Physician and Sportsmedicine, 2019
Collin LaPorte, Marci Vasaris, Leland Gossett, Robert Boykin, Travis Menge
Greater trochanteric pain syndrome (GTPS) is described as pain on the lateral aspect of the hip, and can occasionally radiate down the lateral thigh to the knee [1]. GTPS is commonly seen in clinical practice and was historically felt to be secondary to trochanteric bursitis alone. However, with advances in magnetic resonance imaging (MRI), it has been demonstrated that gluteus medius tendinopathy or tearing is present in most cases of GTPS, and trochanteric bursitis is seldom found in the absence of gluteus medius pathology [2]. Gluteus medius tearing can be a major contributor to GTPS and may be secondary to chronic degeneration or acute trauma. It presents most commonly in females (females to males 4:1) between 40 and 60 years of age. These patients characteristically present with a Trendelenburg gait and lateral hip pain refractory to conservative treatment. It is imperative to fully understand the underlying pathology to be able to properly treat patients presenting with GTPS. While cases of trochanteric bursitis and tendinosis are best managed with non-operative measures, high-grade partial or full thickness gluteus medius tears may require operative intervention. Open and arthroscopic repair techniques have been described for this, with recent literature showing successful outcomes and reduced morbidity with arthroscopic techniques. The purpose of this article is to provide a comprehensive overview of anatomy, clinical evaluation, diagnosis and management of patients with gluteus medius tears.
A preliminary analysis of physical therapist agreement regarding the perceived impairments in cases of runners with knee pain
Published in Physiotherapy Theory and Practice, 2022
Justin Losciale, Katherine Wayman, Cody J. Mansfield, Katherine K. Rethman, Matthew S. Briggs
In case two (Table 5), percent agreement ranged from 8%-100% with only 25% of the impairments having >80% agreement. Trendelenburg gait (impairment 1) was identified as present and clinically important by 11 raters (92% agreement) and inappropriate ankle dorsiflexion at landing (impairment 2) was identified as not present or not clinically important by all 12 raters (100% agreement).