Peritrochanteric access and gluteus medius repair.

Area of Science:

• Orthopedic Surgery
• Minimally Invasive Procedures
• Hip Arthroscopy

Background:

• Lateral hip pain is often caused by gluteus medius tears, frequently misdiagnosed as trochanteric bursitis.
• These tears are a significant cause of chronic pain unresponsive to conservative treatments.
• Endoscopic repair offers a viable treatment option, analogous to shoulder rotator cuff repairs.

Purpose of the Study:

• To describe a simple and reproducible endoscopic technique for accessing the peritrochanteric space.
• To detail the surgical steps for gluteus medius repair using this approach.
• To enhance visualization and treatment of gluteus medius lesions.

Main Methods:

• Utilizing two anteriorly based portals placed between the iliotibial band and greater trochanter for access.
• Clearing bursal tissue and debris to optimize visualization of the peritrochanteric space.
• Employing laterally based portals for repair, with specific placement of viewing and working portals relative to the vastus lateralis ridge.
• Placing anchors perpendicularly to the trochanter's cortical surface from a proximal position.

Main Results:

• The described technique provides simple and reproducible access to the peritrochanteric space.
• Optimized visualization allows for effective management of gluteus medius lesions.
• The procedure facilitates endoscopic repair of gluteus medius tears.

Conclusions:

• Endoscopic repair of gluteus medius tears is feasible and effective using the described technique.
• This approach offers a minimally invasive solution for lateral hip pain.
• The technique is comparable to established endoscopic rotator cuff repair methods.