Isolated Endoscopic Gluteus Medius Repair Can Achieve Successful Clinical Outcomes at Minimum 2-Year Follow-up

Abstract

Purpose: To report on clinical presentations and outcomes in patients who underwent an isolated endoscopic gluteus medius (GM) repair. Methods: We retrospectively reviewed and prospectively collected data on patients who underwent a primary isolated endoscopic GM repair. Patients were included if the following patient-reported outcome scores were obtained preoperatively and at minimum 2-year follow-up: modified Harris Hip Score (mHHS), Non-arthritic Hip Score (NAHS), and visual analog scale (VAS) score. The minimal clinically important difference (MCID) for the mHHS, NAHS, and Hip Outcome ScoreeSports Specific Scale was uniquely calculated for this study. Patients who underwent concomitant procedures including hip arthroplasty and hip arthroscopy were excluded. Results: A total of 26 hips met all inclusion and exclusion criteria, of which 23 hips (88.5%) (22 patients) had a minimum 2-year follow-up. Nineteen hips had a partialthickness GM tear; 17 (89.5%) were high-grade partial-thickness tears treated with a side-to-side repair through a transtendinous window. Four full-thickness tears with no retraction or fatty infiltration were able to be repaired endoscopically. The mHHS, NAHS, and VAS score all significantly improved (P < .05) from baseline: The mHHS improved from 55.9 to 75.4 (P ¼ .005); the NAHS, from 58.8 to 79.2 (P ¼ .003); and the VAS score, from 5.9 to 3.6 (P ¼ .009). The MCID was calculated for the mHHS, NAHS, and Hip Outcome ScoreeSports Specific Scale as 5.8, 7.1, and 11.0, respectively. Most patients achieved the MCID for all 3 patient-reported outcome scores. Conclusions: Appropriately selected patients without concomitant intra-articular hip pathology may achieve successful outcomes at a minimum 2-year follow-up after an isolated endoscopic GM repair. Most isolated endoscopic GM repairs were performed for partial-thickness GM tears. Level of Evidence: Level IV, case-series study.G luteus medius (GM) tears typically present with lateral hip pain, abductor weakness, and gait abnormalities in women older than 50 years. 1 When left untreated, GM tears can cause significant dysfunction and impairment of activities of daily living. Voos et al. 2 initially described endoscopic GM repair with successful outcomes in 10 patients after a shortterm mean follow-up period of 25 months. 3 In this study, all 10 patients also underwent concomitant intraarticular treatment. Subsequent studies have shown

Survivorship, Outcomes, and Risk Factors for Conversion to Total Hip Arthroplasty After Revision Hip Arthroscopic Surgery in Obese Patients: Results at a Minimum 5-Year Follow-up

“…The patients who did not require conversion to THA had a significant preoperative to postoperative improvement in all PROs (P < .01 for all) (Table 5). Additionally, these patients reported high satisfaction (defined as 7/10) 25 at the minimum 2-and 5-year time points (7.2 ± 2.7 and 7.1 ± 2.4, respectively). Also, 16 patients (94.1%) achieved the MCID for the NAHS, and 13 patients (92.9%) achieved the MCID for the HOS-SSS (Table 6).…”

Endoscopic Gluteus Medius Repair

“…Other studies also demonstrated improved visual analogue scale scores from 8 to 2 and from 6 to 4. 8 , 9 Although these improvements are promising, a 2-year follow-up study demonstrated that only 68% of patients returned to preoperative activity, with 23% of patients unable to return directly related to issues with the operative hip. 10 Kirby et al.…”

Satisfactory results after endoscopic gluteus medius repair combined with selective gluteus maximus reflected tendon release for the treatment of a full-thickness tear of gluteus medius

“…The anchors are then placed, followed by confirmation with fluoroscopy. The tears of the gluteus medius of the lateral facet are generally repaired with four anchors spaced evenly across the tendon footprint [ 17 ]. A penetrator is used to pass the suture through the tendon edge.…”