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Mini-Open Technique for Gluteus Medius Tendon Repairs Is Associated With Low Complication Rates and Sustained
Matthew Quinn1, Alex Albright2, Victoria Kent2
1Department of Orthopaedic Surgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, U.S.A.
The hybrid mini-open technique for abductor tendon repair significantly improves hip function and reduces pain at two years. This method shows sustained benefits with low complication rates, comparable to other surgical approaches.
Area of Science:
- Orthopedic Surgery
- Musculoskeletal Research
- Reconstructive Procedures
Background:
- Abductor tendon tears, particularly gluteus medius tears, cause significant hip pain and functional limitations.
- Nonoperative management is often insufficient for refractory cases, necessitating surgical intervention.
- Various surgical techniques exist, including open and endoscopic approaches, each with associated outcomes and complication profiles.
Purpose of the Study:
- To evaluate the long-term efficacy of a hybrid mini-open technique for abductor tendon repair.
- To assess functional outcomes and pain levels at a minimum 2-year follow-up.
- To compare complication rates with existing surgical methods.
Main Methods:
- Retrospective review of prospectively collected data for patients undergoing isolated mini-open gluteus medius tendon repair (January 2018 - January 2022).
- Inclusion criteria: refractory abductor pain, MRI-confirmed tear, and minimum 2-year follow-up.
- Patient-reported outcome measures (PROMs) including mHHS, HOS-ADL, HOS-SS, and VAS were assessed preoperatively and at 6 months, 1 year, and 2 years postoperatively.
Main Results:
- Sixty-one patients (96.7% female, average age 61.4 years) were included with a mean follow-up of 25.9 months.
- Significant improvements observed: mHHS (47.2 to 68.9, P < 0.001), HOS-ADL (54 to 78.9, P < 0.001), HOS-SS (37 to 66.5, P = 0.015), and VAS (13.3 to 7.4, P = 0.001).
- Achieved MCID: mHHS (60%), HOS-ADL (78.6%), HOS-SS (80.3%), VAS (75.4%). Two retears (3.2%) occurred with no other complications.
Conclusions:
- The hybrid mini-open technique offers sustained improvements in pain and function for abductor tendon tears at 2-year follow-up.
- Outcomes demonstrate significant patient-reported improvements exceeding minimal clinically important differences.
- Complication rates are comparable to established endoscopic and open repair techniques.
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