Sivashankar Chandrasekaran1, Chengcheng Gui1, Mark R Hutchinson2, Parth Lodhia1, Carlos Suarez-Ahedo1, Benjamin G Domb1. 1. 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. 2. University of Illinois at Chicago, 1901 West Taylor Street, Chicago, IL 60612. E-mail address: mhutch@uic.edu.
Abstract
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.
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.
Authors: David R Maldonado; Shawn Annin; Jeffery W Chen; Philip J Rosinsky; Jacob Shapira; Ajay C Lall; Benjamin G Domb Journal: Orthop J Sports Med Date: 2020-07-10
Authors: Carlos Suarez-Ahedo; Chengcheng Gui; Stephanie M Rabe; John P Walsh; Sivashankar Chandrasekaran; Benjamin G Domb Journal: Orthop J Sports Med Date: 2017-11-29
Authors: David R Maldonado; Shawn Annin; Jeffrey W Chen; Mitchell J Yelton; Jacob Shapira; Philip J Rosinsky; Ajay C Lall; Benjamin G Domb Journal: JB JS Open Access Date: 2020-11-25