Endoscopic gluteus medius partial tear repair with collagen patch augmentation. Clinical and imaging results

Abstract

Introduction: Gluteus medius (GM) partial and total tears are often the cause of lateral hip pain. Non-surgical management is the first approach, however, open and endoscopic repair techniques have been described in refractory cases. The use of collagen patches has been proposed as an augmentation to enhance healing. This study aims to describe our technique for repairing partial tears of the GM tendon and present clinical and imaging results. Materials and methods: Prospective cohort on 15 hips with lateral hip pain and a positive Trendelenburg test, who had a partial thickness tear of the GM tendon on MRI. The patients had not responded to non-surgical treatment for at least 6 months and underwent endoscopic repair with a collagen patch augmentation between 2019 and 2022. The postoperative Modified Harris Hip Score (mHHS), International Hip Outcomes Tool-12 (iHOT-12), Visual Analogue Score (VAS), patient satisfaction, Trendelembug test, and control MRI to assess healing at 3 months were obtained. Results: 100% female, mean age of 56.66 years. Mean follow-up was 11 (4-24) months. Median mHHS improved significantly from 68 to 82 points (p=0.001). The median iHOT-12 improved significantly from 70 to 83 points (p=0.001). Median VAS decreased significantly from 6 to 2 (p<0.001). All patients had a negative Trendelenburg test at the end of the follow-up, and all reported being satisfied. There were no complications and all cases showed healing. Conclusion: Our endoscopic technique has shown positive clinical outcomes for patients with partial ruptures, resulting in complete healing without short-term complications.