Endoscopic Repair of Full-Thickness Gluteus Medius and Minimus Tears—Prospective Study With a Minimum 2-Year Follow-Up

Nazal, Mark R.; Abraham, Paul; Conaway, William; Quinlan, Noah J.; Gillinov, Stephen M.; Gibbs, Jada S.; Upadhyaya, Shivam; Alpaugh, Kyle; Martin, Scott D.

doi:10.1016/j.arthro.2020.04.025

Cited by 25 publications

(26 citation statements)

References 24 publications

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“…However, we believe that the high-resolution rate of poor sleep quality in the postoperative period is strong evidence that open HAT repair played an essential role in improving sleep.There was also a high proportion of female patients in our cohort, limiting the magnitude to male patients. However, these results are consistent with previous studies [ 1 , 11 , 42 ] and demonstrate the higher prevalence of this pathology in female patients. To date, the PSQI has not yet been fully implemented in orthopedic surgery, however, it is used in the majority of studies examining sleep quality [ 23 , 24 , 25 , 26 ].…”

Section: Limitationssupporting

confidence: 93%

“…Patients with HAT present with lateral hip pain, hypersensivity to palpation of the greater trochanter, debilitated hip abduction against resistance, and a positive Trendelenburg sign. These symptoms are excacerbated by walking long distances, walking up and down stairs, or sleeping on the affected side [ 11 , 12 , 13 ]. With conservative therapy failing, the option of open or endoscopic surgical treatment of HAT is considered.…”

Section: Introductionmentioning

confidence: 99%

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Open Hip Abductor Repair Hitting the Sack-Abductor Tendon Repair Significantly Improves Sleep Quality

Zimmerer

Navas

Pfeil

et al. 2021

JCM

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Purpose: To (1) describe the prevalence of abnormal sleep quality in patients with hip abductor tears (HAT), to (2) determine whether sleep quality improves after open HAT repair, and to (3) to report clinical short-term outcomes in patients undergoing open HAT repair. Methods: The data of 28 patients (29 hips) who underwant open HAT repair were prospectively analyzed at midterm follow-up. The Pittsburgh Sleep Quality Index (PSQI), modified Harris Hip Score (mHHS), the University of California, Los Angeles activity scale (UCLA), and Visual Analog Scale (VAS) for pain were determined via questionnaire. Paired t-tests were applied to compare preoperative and post-operative Patient-reported Outcome Measures (PROMs). Logistic regression was performed to determine the association between PSQI improvement achievement and demographic variables (laterality, sex, age, body-mass-index (BMI), and preoperative mHHS). The minimal clinically important difference (MCID) was calculated for the mHHS. Results: A total of 28 patients were included. Four patients (14.3%) suffered post-operative complications after open HAT repair. The predominance of patients was female (77.4%), with a mean age of 60 ± 13 years. The average follow-up was 30.35 ± 16.62 months. Preoperatively, 27 (96.4%) patients experienced poor sleep quality (PSQI > 5); at follow-up, 7 (25%) patients experienced poor sleep quality. Univariate logistical regression analysis demonstrated no significant association between preoperative demographic data and achieving postoperative PSQI < 5. The MCID of mHHS was calculated to be 12.5. Overall, 90% of patients achieved MCID for mHHS. Conclusion: Preoperative sleep quality was impaired in 96.4% of HAT patients (PSQI > 5). However, these patients showed an improvement in sleep disturbances after open HAT repair in the early postoperative period. Ninety percent of patients showed significant improvements in mHHS and achieved the corresponding MCID. Level of Evidence: Case series; Level IV.

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Section: Limitationssupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Open Hip Abductor Repair Hitting the Sack-Abductor Tendon Repair Significantly Improves Sleep Quality

Zimmerer

Navas

Pfeil

et al. 2021

JCM

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“…This is of particular interest because such a low post-operative pain level is known to be associated with a considerable reduction of opioid consumption [ 44 ]. Improvements in PROMs seem to be associated with functional results given that all our patients (100%) improved their abduction strength by at least one grade, which is greater than the proportions reported by Maldonado et al [ 18 ] (44%), Nazal et al [ 41 ] (53%) and Hartigan et al [ 39 ] (64%). The present series also revealed the complete disappearance of gait dysfunction at last clinical evaluation, which is consistent with the findings of Hartigan et al [ 39 ] who observed Trendelenburg gait disappearance in 86% of his patients.…”

Section: Discussioncontrasting

confidence: 56%

“…To the authors’ knowledge, the post-operative mHHS reported in our series (93 points) is above every single result published in the existing literature (68–86 points) at different follow-up time points [ 13 , 14 , 17 , 18 , 20 , 38–43 ]. Likewise, the post-operative pain reported in the present series (median, 1) is one of the greatest (lowest) values reported in the literature, which ranges from 0.5 to 3.4 points [ 13 , 14 , 17 , 18 , 20 , 38 , 39 , 41–43 ]. This is of particular interest because such a low post-operative pain level is known to be associated with a considerable reduction of opioid consumption [ 44 ].…”

Section: Discussionsupporting

confidence: 53%

Short-term outcomes following mini-open repair of chronic gluteus medius tendon tears using a double-row technique

Barrera

Bothorel

Poultsides

et al. 2021

Journal of Hip Preservation Surgery

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Gluteal tendon tears represent a common but underreported cause of lateral hip pain and dysfunction. In case of conservative management failure, a surgical procedure must be performed to relieve patient symptoms. Current operative treatments, either open or endoscopic, have been however associated with different drawbacks which led to the introduction of the mini-open technique. The aim of this study was to evaluate and report the short-term outcomes of patients operated through the aforementioned surgical technique for gluteus medius (GM) chronic tears. We retrospectively analysed the records of 14 consecutive patients operated at the La Tour hospital by mini-open repair using a double-row technique for full-thickness GM chronic tears. Intra- and post-operative complications were recorded. The pre- and post-operative pain on visual analogue scale (pVAS), modified Harris Hip score (mHHS), abduction strength and gait dysfunction were assessed for all patients. Pre- and post-operative values were compared to evaluate whether improvements were statistically significant and clinically relevant. The study cohort comprised 13 women (93%) and 1 man (3%) aged 62.4 ± 18.0 at index surgery. No intra- or post-operative complications were noted. Compared to pre-operative values, patients reported a significant improvement in mHHS (59.1 ± 7.1 vs 92.7 ± 4.6) and pVAS (7.4 ± 1.0 vs 1.3 ± 1.3) at last follow-up. Patients exhibited a perfect improvement in muscle strength (3.6 ± 0.5 vs 5.0 ± 0.0), and the proportion of patients with a positive Trendelenburg sign decreased from 71% to 0%. Mini-open repair of chronic GM tendon tears using a double-row technique demonstrated excellent clinical and functional outcomes at short follow-up. Level of Evidence: IV.

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“…7 A prospective case series including 15 hips having isolated endoscopic repair of full-thickness hip abductor tears with a minimum 2-year follow-up resulted in 100% patient satisfaction. 8 Fatty degeneration of the abductor muscles 9 or associated scoliosis 10 has a negative effect on the outcome of gluteus medius repair.…”

mentioning

confidence: 99%

Hip Gluteus Medius and Minimus Endoscopic Treatment Results in Patient Satisfaction

Lubowitz¹,

Brand²,

Rossi³

2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Greater trochanteric pain syndrome includes a spectrum of hip pathology, including trochanteric bursitis, gluteus medius or minimus tendinosis, partial abductor tear, full-thickness tear, and full-thickness tear plus retraction (with or without fatty atrophy). Physical diagnosis includes palpation for tenderness at the greater trochanter and evaluation for strength loss, including observation of gait. Women are significantly more likely to have a tear of the hip abductors than men. Endoscopic treatment results in patient satisfaction, improved strength and gait, and few complications. Fatty degeneration of the abductor muscles or associated scoliosis has a negative effect on the outcome of gluteus medius repair.

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Endoscopic Repair of Full-Thickness Gluteus Medius and Minimus Tears—Prospective Study With a Minimum 2-Year Follow-Up

Cited by 25 publications

References 24 publications

Open Hip Abductor Repair Hitting the Sack-Abductor Tendon Repair Significantly Improves Sleep Quality

Open Hip Abductor Repair Hitting the Sack-Abductor Tendon Repair Significantly Improves Sleep Quality

Short-term outcomes following mini-open repair of chronic gluteus medius tendon tears using a double-row technique

Hip Gluteus Medius and Minimus Endoscopic Treatment Results in Patient Satisfaction

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