Offene Refixation von Gluteus medius und minimus in Double-Row-Technik

Abstract

Operative reconstruction of lesions in the hip abductor tendons is a therapy option with significant improvement of patient satisfaction and functional scores as well as muscle diameter and cross-sectional area for the gluteus medius. The degree of fatty degeneration and possible differential diagnoses need to be taken into consideration.

Correlation of the Subjective Hip Value with Validated Patient-Reported Outcome Measurements for the Hip

“…It reflects the perspective of the patient and is easily administered and time-saving for the patient and the investigator. Although the subjective hip value has been used to report on results after hip arthroscopy, cartilage implantation of the hip and muscular reconstructions of the hip abductors, it has never been evaluated before [ 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 ]. We could show a high and statistically significant correlation between the subjective hip value and established hip measures such as the modified Harris hip score and the International Hip Outcome Tool.…”

Lesions of the abductors in the hip

“…Outcomes worsen for higher Goutallier classification scores. 59 McGonagle et al demonstrated no improvement in tendon and muscle quality postoperatively in 15 patients who underwent open repair with anchors. Again, no preoperative Goutallier grading was provided and tendon quality intraoperatively was not mentioned.…”

“…During open procedures, the patient is usually placed in the lateral decubitus position, and an incision centred over the greater trochanter or a posterolateral approach is used. 57 – 59 Following the exposure of the gluteal attachment, the quality, type and extent of the rupture of the gluteal tendons are assessed. Partial-thickness GMed tears often develop in the tendon undersurface, and recognition of the lesion is difficult.…”

“…GMin tears are similarly managed using fewer anchors due to the smaller insertion area and capsular attachments of muscle. 59 When needed, the blunt release of gluteal muscles is performed, taking care to preserve the superior gluteal nerve or elongation of fascia lata using a V-Y technique. Postoperatively, non-weight-bearing or partial weight-bearing walking for six weeks, avoiding active hip abduction, is followed.…”

“…Postoperatively, non-weight-bearing or partial weight-bearing walking for six weeks, avoiding active hip abduction, is followed. 57 – 59 …”