Botulinum toxin type A injections for the management of muscle tightness following total hip arthroplasty: a case series.

Published online

Journal Article

BACKGROUND: Development of hip adductor, tensor fascia lata, and rectus femoris muscle contractures following total hip arthroplasties are quite common, with some patients failing to improve despite treatment with a variety of non-operative modalities. The purpose of the present study was to describe the use of and patient outcomes of botulinum toxin injections as an adjunctive treatment for muscle tightness following total hip arthroplasty. METHODS: Ten patients (14 hips) who had hip adductor, abductor, and/or flexor muscle contractures following total arthroplasty and had been refractory to physical therapeutic efforts were treated with injection of botulinum toxin A. Eight limbs received injections into the adductor muscle, 8 limbs received injections into the tensor fascia lata muscle, and 2 limbs received injection into the rectus femoris muscle, followed by intensive physical therapy for 6 weeks. RESULTS: At a mean final follow-up of 20 months, all 14 hips had increased range in the affected arc of motion, with a mean improvement of 23 degrees (range, 10 to 45 degrees). Additionally all hips had an improvement in hip scores, with a significant increase in mean score from 74 points (range, 57 to 91 points) prior to injection to a mean of 96 points (range, 93 to 98) at final follow-up. There were no serious treatment-related adverse events. CONCLUSION: Botulinum toxin A injections combined with intensive physical therapy may be considered as a potential treatment modality, especially in difficult cases of muscle tightness that are refractory to standard therapy.

Full Text

Duke Authors

Cited Authors

  • Bhave, A; Zywiel, MG; Ulrich, SD; McGrath, MS; Seyler, TM; Marker, DR; Delanois, RE; Mont, MA

Published Date

  • August 26, 2009

Published In

Volume / Issue

  • 4 /

Start / End Page

  • 34 -

PubMed ID

  • 19709429

Pubmed Central ID

  • 19709429

Electronic International Standard Serial Number (EISSN)

  • 1749-799X

Digital Object Identifier (DOI)

  • 10.1186/1749-799X-4-34


  • eng

Conference Location

  • England