Transfemoral Amputation Adductor Myodesis Using FiberTape and Knotless Anchors

Abstract

Transfemoral amputation is considered the last treatment option for severe infection, vascular disease, trauma, and malignant tumors of the lower extremity that have failed limb salvage. Unopposed pull of the hip abductors causes a flexion-abduction thigh deformity that results in abnormal biomechanics and increased oxygen consumption during ambulation. Myodesis of the adductor tendons is a critical component of transfemoral amputation that creates dynamic muscle balance, enhances prosthetic fitting and function, and improves clinical outcomes. Traditional adductor myodesis uses locking sutures passed through cortical drill holes along the anterolateral aspect of the distal femur that are tensioned and tied by hand. In this report we describe a novel technique for adductor myodesis using FiberTape suture and knotless anchors that we have found to be quick, easy, and reproducible with strong tendon-bone fixation. Level of Evidence: Level V, expert opinion.