Endoscopic Repair of Partial-Thickness Undersurface Tears of the Abductor Tendon: Clinical Outcomes With Minimum 2-Year Follow-up

Hartigan, David E.; Perets, Itay; Ho, Sherwin S.W.; Walsh, John P.; Yuen, Leslie C.; Domb, Benjamin G.

doi:10.1016/j.arthro.2017.10.022

Cited by 56 publications

(72 citation statements)

References 12 publications

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“…2,8,28 Despite first being reported in 1997 by Bunker et al, 4 a review 13 published in 2015 highlighted encouraging outcomes in patients embarking on HAT surgical repair via a range of surgical techniques, with numerous open, endoscopic, and augmented techniques reported since that time. 5,14,22,[24][25][26]31,33 Interestingly, only a few of these studies 14,22,37,47 actually documented outcomes in more than 30 patients, with a recent review summarizing the surgical outcomes of patients undergoing HAT repair reporting that many studies lack detail on the patient cohort, postoperative care, and clinical follow-up. 13 Furthermore, despite the encouraging published outcomes, satisfaction rates vary across studies, ranging from 66% to 90%, 3,10,36,[38][39][40]42 and surgical failure rates as high as 31% and 33% have been cited.…”

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confidence: 99%

A Prospective 2-Year Clinical Evaluation of Augmented Hip Abductor Tendon Repair

Ebert

Brogan

Janes

2020

Orthopaedic Journal of Sports Medicine

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Background: Hip abductor tendon (HAT) tearing is commonly implicated in greater trochanteric pain syndrome. Studies reporting surgical outcomes are often on small cohorts and with limited information on functional improvement. Purpose: To report the 2-year clinical and functional outcomes in a series of patients undergoing HAT repair augmented with a ligament augmentation and reconstruction system (LARS) ligament. Study Design: Case series; Level of evidence, 4. Methods: Between October 2012 and December 2016, a total of 142 patients with symptomatic HAT tears underwent open bursectomy, V-Y lengthening, and reattachment of the tendon with suture anchors augmented with a LARS ligament. This included 132 women (93%) with a mean age of 64.3 years (range, 43-84 years), a mean body mass index of 28.2 kg/m2 (range, 20.0-41.3 kg/m2), and an average duration of symptoms of 4.0 years (range, 6 months-20 years). Following surgery, patients underwent a graduated rehabilitation program consisting of hydrotherapy and land-based exercises. Patient-reported outcome measures (PROMs) were evaluated preoperatively and at 3, 6, 12, and 24 months postoperatively with the Harris Hip Score, Oxford Hip Score, 12-item Short Form Health Survey, and visual analog scale (VAS) for pain. Hip range of motion, hip abduction strength, 30-s single-leg stance (SLS), and 6-minute walk test (6MWT) capacity were evaluated. Patient satisfaction and perceived global rating of change were evaluated postsurgery. Analysis of variance was employed to evaluate clinical improvement over time. Results: A significant improvement ( P < .05) was demonstrated up to 24 months in all PROMs and clinical scores, including hip range of motion in all planes, hip abductor strength limb symmetry indices (mean ± SD; presurgery, 90.1% ± 42.5%; 24 months, 102.6% ± 15.0%), and the 6MWT (presurgery, 421.8 ± 91.9 m; 24 months, 509.7 ± 105.1 m). Furthermore, several variables, including pain (VAS and pain scores during the 6MWT and 30-s SLS) and patient-perceived improvement (global rating of change), continued to improve from 12 to 24 months. At 24 months, 95.7% of patients were satisfied with their surgical outcome (excluding 3 patients who underwent reoperation within the 24-month period). There was a 5.6% (n = 8) failure rate over the study period. Conclusion: HAT repair augmented with a synthetic ligament demonstrated significantly improved clinical and functional outcomes, high levels of patient satisfaction, and a relatively low failure rate up to 24 months postsurgery. Registration: ACTRN12616001655437 (Australian New Zealand Clinical Trials Registry).

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confidence: 99%

A Prospective 2-Year Clinical Evaluation of Augmented Hip Abductor Tendon Repair

Ebert

Brogan

Janes

2020

Orthopaedic Journal of Sports Medicine

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“…A total of 7 articles were therefore assessed. Finally, 4 articles were included for the qualitative analysis: Hartigan et al (Hartigan et al, 2018), Thaunat et al (Thaunat et al, 2013), and . Two articles were excluded with reasons: Voos et al (Voos et al, 2009) and…”

Section: Study Selectionmentioning

confidence: 99%

“…The mean follow-up was 18 months, ranging from 6 months (Thaunat et al, 2013) to 36 months . According to the Coleman Methodologic Score (CMS), 2 articles Thaunat et al, 2013) were of poor quality (<50), and two Hartigan et al, 2018) of fair quality (58 and 59). The median CMS was 51.5 (43-59) of a possible 100 total score.…”

Section: S774mentioning

confidence: 99%

“…Gluteus tears are more often characterized by chronic pain onset generated by attritional forces than acute traumatic pain (Chandrasekaran, Gui, et al, 2015;Domb & Carreira, 2013). Generally, patients suffer of pain on weight-bearing and during climbing or descending stairs, limping with a typical Trendelenburg gait Hartigan et al, 2018;Thaunat et al, 2016). Recognize and treat a partial-thickness under surface tears represent a challenge for orthopaedic surgeons because they cannot be visualized directly from the peritrochanteric space (Hartigan et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

“…Generally, patients suffer of pain on weight-bearing and during climbing or descending stairs, limping with a typical Trendelenburg gait Hartigan et al, 2018;Thaunat et al, 2016). Recognize and treat a partial-thickness under surface tears represent a challenge for orthopaedic surgeons because they cannot be visualized directly from the peritrochanteric space (Hartigan et al, 2018). For this purpose, patients history, symptoms and imaging are fundamental.…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of endoscopic trans-tendineous repair for partial-thickness tears of medius gluteus: A systematic review of literature

D’Addona¹,

Rocca²,

Carrella³

et al. 2020

Journal of Human Sport and Exercise - 2020 - Spring Conferences of Sports Science

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Tears of the gluteus medius can result in chronic hip pain over time. Pathological onsets involving the gluteus medius cause pain and weakness of abductor strength. Endoscopic repair is a suitable, effective and safe surgical alternative to traditional open techniques and give satisfactory results over time restoring the footprint of gluteus medius. The purpose of this systematic review is to analyse the effectiveness of endoscopic transtendinous technique for partial-thickness tears, analysing the subjective and functional outcome over the time. A search of literature (PubMed, Scopus, WebOfKnowledge) was performed. The PRISMA method was used to screen the articles. A total of 4 articles was screened and included for qualitative analysis. For data extraction patient characteristics, pre-clinical examination, imaging, timing from symptoms to surgery, technique performed, subjective scales, functional outcomes, post-operative clinical assessment were analysed. Subjective scores at mean follow-up of 18 months show a significative improvement in all the scales reported, in relief of pain (VAS score) and in terms of strength of abductor. Trans-tendinous technique represents the gold standard to treat endoscopically these injuries. Furthermore, other studies with larger number of patients and longer follow-up are required to validate the best surgical approach for these injuries.

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Surgical Technique: Endoscopic Repair of Partial-Thickness Gluteus Tears

Sullivan

Nwachukwu

2021

Hip Arthroscopy and Hip Joint Preservation Surgery

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Endoscopic Repair of Partial-Thickness Undersurface Tears of the Abductor Tendon: Clinical Outcomes With Minimum 2-Year Follow-up

Cited by 56 publications

References 12 publications

A Prospective 2-Year Clinical Evaluation of Augmented Hip Abductor Tendon Repair

A Prospective 2-Year Clinical Evaluation of Augmented Hip Abductor Tendon Repair

Effectiveness of endoscopic trans-tendineous repair for partial-thickness tears of medius gluteus: A systematic review of literature

Surgical Technique: Endoscopic Repair of Partial-Thickness Gluteus Tears

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