Background: Proximal hamstring ruptures meeting operative criteria may be treated through endoscopic, open, or combined techniques. Open techniques allow for facilitated tendon visualization and mobilization with ease of suture passage. Indications: Proximal hamstring repairs are indicated for complete 3 tendon avulsions; partial avulsions with 2 or more tendons involved with more than 2 cm of retraction in young, active patients; and partial avulsion injuries or chronic tears that remain refractory to conservative treatment. Technique Description: Through an incision along the gluteal crease, the tendon stump is identified and mobilized. Anchors are placed in the prepped ischium and sutures are passed through the tendon in a running fashion. The tendon is secured to its origin in a docking technique. Results: Patients undergoing hamstring repair have high satisfaction rates and patient-reported outcome scores. Competitive and elite athletes have demonstrated reliable return-to-sport rates at presurgical levels. Discussion: Open proximal hamstring repairs produce reliable results. The open technique is advantageous for its ease of tendon mobilization, direct visualization, and suture passage. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

Background: There is a paucity of information available to clinicians on outcomes of patients undergoing endoscopic surgery for labral repairs and femoroacetabular impingement syndrome with simultaneous repair of the gluteus medius and/or minimus muscles. Purpose: To determine whether patients with labral tears and concomitant gluteal pathology who undergo simultaneous endoscopic labral and gluteus medius and/or minimus repair experience similar outcomes to patients with isolated labral tears who undergo endoscopic labral repair alone. Study Design: Cohort study; Level of evidence, 3. Methods: A matched retrospective comparative cohort study was performed. Patients who underwent gluteus medius and/or minimus repair with concomitant labral repair between January 2012 and November 2019 were identified. These patients were matched in a 1:3 ratio by sex, age, and body mass index (BMI) to patients who underwent labral repair alone. Preoperative radiographs were assessed. Patient-reported outcomes (PROs) were assessed preoperatively and 2 years postoperatively. PRO measures included the Hip Outcome Score Activities of Daily Living and Sports subscales, modified Harris Hip Score, 12-Item International Hip Outcome Tool, and visual analog scales for pain and satisfaction. Published labral repair minimal clinically important difference (MCID) and Patient Acceptable Symptom State (PASS) thresholds were utilized for these measures. Results: A total of 31 patients who underwent gluteus medius and/or minimus repair with concomitant labral repair (27 female, 4 male; age, 50.8 ± 7.3 years; BMI, 27.9 ± 5.2) were matched with 93 patients who underwent labral repair alone (81 female, 12 male; age, 50.9 ± 8.1 years; BMI, 28.5 ± 6.2). There were no significant differences in sex ( P > .99), age ( P = .869), or BMI ( P = .592); preoperative radiographic measurements; or preoperative or 2-year postoperative PRO scores ( P≥ .081). Changes between preoperative and 2-year postoperative PRO scores were significantly different for both groups for all PROs assessed ( P < .001 for all). There were no significant differences in MCID or PASS achievement rates ( P≥ .123), with low PASS achievement rates of 40% to 60% found in both groups. Conclusion: Patients who were treated with endoscopic gluteus medius and/or minimus repair with concomitant labral repair demonstrated comparable outcomes with those who were treated with endoscopic labral repair alone.

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: The authors observe significant bone gaps upon distractor removal in posterior vault distraction osteogenesis (PVDO). The purpose of this study was to quantify bone gaps upon distractor removal, determine whether they close over time, determine if they predispose to relapse, and investigate whether age affects rate and degree of re-ossification. The authors performed a retrospective review of PVDO patients and included those with computed tomography (CT) scans at 2 timepoints: 1 at completion of consolidation and another at least 4 months later. Using Mimics software, bone gaps were traced to calculate total surface area. A paired t test and linear regression were used to compare size of bone gaps, presence of relapse, and rates of re-ossification. Sixty-nine patients were identified, with 7 meeting inclusion criteria. Three were under 1 year. Consolidation began 28.3 ± 6.0 days after surgery and continued for 64.9 ± 14.5 days. Length of time between CT scans was 7.5 ± 2.7 months. A significant decrease in bone gaps occurred between scans (33.4 ± 14.6 cm2 versus 19.2 ± 17.2 cm2, P = 0.005). After consolidation, ossification occurred at a rate of 2.4 cm2/month (P = 0.046). The rate of bony regeneration in patients under and over 1 year was 4.3 cm3/month (P = 0.025) and 1.5 cm3/month (P = 0.552), respectively. Despite differential bony regeneration rates, no patient demonstrated relapse. From this study, the authors conclude the following. Calvarial bone gaps are present after PVDO consolidation. These gaps undergo re-ossification at a rate that appears to be faster in infants. Overall, they decrease in size over time. The presence of bone gaps does not correlate with relapse of cranial expansion.