Outcomes of Endoscopic Gluteus Medius Repair: Study of Thirty-four Patients with Minimum Two-Year Follow-up.
BACKGROUND
Surgical intervention for partial and full-thickness gluteus medius tears is often recommended for patients who have persistent pain despite nonoperative treatment. Traditionally, the surgical intervention has been carried out through open techniques with good results; however, advantages of endoscopic techniques include less tissue dissection, improved tendon mobilization, and the benefit of arthroscopic correction of intra-articular pathological conditions. The purpose of this report is to provide an update on a previously published study of patients with a gluteus medius tear, with inclusion of additional patients followed for a minimum of two years.


METHODS
The study included thirty-four patients who had undergone an endoscopic gluteus medius repair with correction of intra-articular pathological conditions between April 2009 and April 2012 and had been followed for a minimum of two years. Patient-reported outcome measures included the modified Harris hip score, Nonarthritic Hip Score, and Hip Outcome Score-Activities of Daily Living and Sport-Specific Subscale. A visual analog scale (VAS) pain score and a patient satisfaction score were also recorded.


RESULTS
The cohort consisted of two men and thirty-two women with a mean age of fifty-seven years (range, twenty to seventy-nine years). Ten patients had a full-thickness tear, and twenty-four patients had a partial-thickness tear. Seventeen patients were treated with a suture bridge technique, after completion of the tear if it was not already complete, and seventeen patients were treated with the transtendinous technique. All patients had surgical correction of intra-articular pathological conditions. There was a significant improvement in all four patient-reported outcomes at three specified time-points. The mean VAS pain score decreased from 6.6 preoperatively to 2.4 at the time of the two-year follow-up (p < 0.001). The mean satisfaction score was 8.5 at two years postoperatively. Of twenty-six patients who had a gait deviation preoperatively, fifteen (58%) regained a completely normal gait. There was no significant difference in patient-reported outcome measures between the two surgical techniques. Four patients required total hip replacement at eleven to sixteen months postoperatively.


CONCLUSIONS
After a minimum of two years of follow-up, endoscopic surgical repair with correction of intra-articular pathological conditions was found to be an effective treatment for patients with a gluteus medius tear.
American Hip Institute, 1010 Executive Court, Suite 250, Westmont, IL 60559. E-mail address for S. Chandrasekaran: siva_shankar@hotmail.com. E-mail address for C. Gui:chengchenggui@gmail.com. E-mail address for P. Lodhia: parthlodhia@gmail.com. E-mail address for C. Suarez-Ahedo: drsuarezahedo@gmail.com. E-mail address for B.G. Domb: DrDomb@americanhipinstitute.org.
Sivashankar
S
Chandrasekaran
American Hip Institute, 1010 Executive Court, Suite 250, Westmont, IL 60559. E-mail address for S. Chandrasekaran: siva_shankar@hotmail.com. E-mail address for C. Gui:chengchenggui@gmail.com. E-mail address for P. Lodhia: parthlodhia@gmail.com. E-mail address for C. Suarez-Ahedo: drsuarezahedo@gmail.com. E-mail address for B.G. Domb: DrDomb@americanhipinstitute.org.
Chengcheng
C
Gui
University of Illinois at Chicago, 1901 West Taylor Street, Chicago, IL 60612. E-mail address: mhutch@uic.edu.
Mark R
MR
Hutchinson
American Hip Institute, 1010 Executive Court, Suite 250, Westmont, IL 60559. E-mail address for S. Chandrasekaran: siva_shankar@hotmail.com. E-mail address for C. Gui:chengchenggui@gmail.com. E-mail address for P. Lodhia: parthlodhia@gmail.com. E-mail address for C. Suarez-Ahedo: drsuarezahedo@gmail.com. E-mail address for B.G. Domb: DrDomb@americanhipinstitute.org.
Parth
P
Lodhia
American Hip Institute, 1010 Executive Court, Suite 250, Westmont, IL 60559. E-mail address for S. Chandrasekaran: siva_shankar@hotmail.com. E-mail address for C. Gui:chengchenggui@gmail.com. E-mail address for P. Lodhia: parthlodhia@gmail.com. E-mail address for C. Suarez-Ahedo: drsuarezahedo@gmail.com. E-mail address for B.G. Domb: DrDomb@americanhipinstitute.org.
Carlos
C
Suarez-Ahedo
American Hip Institute, 1010 Executive Court, Suite 250, Westmont, IL 60559. E-mail address for S. Chandrasekaran: siva_shankar@hotmail.com. E-mail address for C. Gui:chengchenggui@gmail.com. E-mail address for P. Lodhia: parthlodhia@gmail.com. E-mail address for C. Suarez-Ahedo: drsuarezahedo@gmail.com. E-mail address for B.G. Domb: DrDomb@americanhipinstitute.org.
Benjamin G
BG
Domb
D000328:Adult; D000368:Aged; D002081:Buttocks; D015331:Cohort Studies; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D016658:Psoas Muscles / Q000293:injuries / Q000601:surgery; D012189:Retrospective Studies; D018570:Risk Assessment; D053441:Suture Anchors; D013536:Suture Techniques; D013708:Tendon Injuries / Q000175:diagnosis* / Q000601:surgery*; D013710:Tendons / Q000601:surgery*; D013718:Tensile Strength; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult