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Endoscopic repair of full-thickness gluteus medius tears.

ABSTRACT: Tears in the gluteus medius and minimus tendons recently have emerged as an important cause of chronic greater trochanteric pain syndrome. Increasing recognition of the gluteal insertion as a cause of chronic pain and weakness, as well as technologic advances in endoscopic hip surgery, has made gluteal insertional repair a rapidly emerging technique in minimally invasive surgery of the hip. We present an endoscopic double-row technique for gluteal insertional repair that allows for visualization, debridement, and repair, re-creating the normal footprint.

SUBMITTER: Domb BG

PROVIDER: S-EPMC3716195 | biostudies-literature | 2013 May

REPOSITORIES: biostudies-literature

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Endoscopic repair of full-thickness gluteus medius tears.

Domb Benjamin G BG Carreira Dominic S DS

Arthroscopy techniques 20130309 2

Tears in the gluteus medius and minimus tendons recently have emerged as an important cause of chronic greater trochanteric pain syndrome. Increasing recognition of the gluteal insertion as a cause of chronic pain and weakness, as well as technologic advances in endoscopic hip surgery, has made gluteal insertional repair a rapidly emerging technique in minimally invasive surgery of the hip. We present an endoscopic double-row technique for gluteal insertional repair that allows for visualization ...[more]

PMID: 23875154

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All-Endoscopic Single-Row Repair of Full-Thickness Gluteus Medius Tears.

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Endoscopic Gluteus Medius and Minimus Repair With Allograft Augmentation Using Acellular Human Dermis.

Project description:Recently, attention has been given to recalcitrant lateral hip pain, also known as greater trochanteric pain syndrome. Although, historically, this has been attributed to greater trochanteric bursitis, the literature has shown that many patients will have a lesion of the gluteus medius and minimus tendons. Endoscopic hip abductor tendon repair has been shown to provide good outcomes with decreasing overall morbidity and is becoming more popular. However, failure rates have been reported to be as high as 35%, likely due to the poor tissue quality in this older population. Acellular human dermal allograft has been used to augment rotator cuff repairs in an attempt to improve tendon healing. The technique described in this Technical Note shows endoscopic gluteus medius and minimus repair with acellular human dermal allograft augmentation focusing on graft preparation, implantation, and fixation in a safe and reproducible manner.

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Surgical Treatment of Gluteus Medius Tears Augmented With Allograft Human Dermis.

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

Project description:PurposeTo report on clinical presentations and outcomes in patients who underwent an isolated endoscopic gluteus medius (GM) repair.MethodsWe 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 Score-Sports Specific Scale was uniquely calculated for this study. Patients who underwent concomitant procedures including hip arthroplasty and hip arthroscopy were excluded.ResultsA 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 partial-thickness 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 = .005); the NAHS, from 58.8 to 79.2 (P = .003); and the VAS score, from 5.9 to 3.6 (P = .009). The MCID was calculated for the mHHS, NAHS, and Hip Outcome Score-Sports Specific Scale as 5.8, 7.1, and 11.0, respectively. Most patients achieved the MCID for all 3 patient-reported outcome scores.ConclusionsAppropriately 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 evidenceLevel IV, case-series study.

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Open Gluteus Medius and Minimus Repair With Double-Row Technique and Bioinductive Implant Augmentation.

Project description:Lateral hip pain in patients without significant osteoarthritis may be due to a number of different etiologies. Recent attention has been placed on the role of abductor tendon (gluteus medius and minimus) deficiency in these patients. These tears, analogous to rotator cuff tears in the shoulder, may cause pain, weakness, limp, and dysfunction. Mainstays of treatment include nonoperative treatment and, in select patients, operative fixation. This article presents an overview of management of patients with symptomatic, large, retracted, chronic tears of the abductor tendons. The highlighted repair is a "double-row" repair with biological patch augmentation.

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