Hip Arthroscopy With Concomitant Endoscopic Gluteus Medius/Minimus Repair

Gluteus medius and minimus tears can lead to significant lateral hip pain, abductor weakness, and functional impairment. These tears are more frequently seen in middle-aged and older adults. These tears typically involve the anterolateral portion of the tendon footprint on the greater trochanter and can range in degree and severity. Gluteus medius and minimus tears most commonly develop due to chronic tendinous degeneration but may also arise as a result of acute trauma. Endoscopic repair has emerged as a more minimally invasive alternative to open techniques, offering effective tendon reattachment via suture anchors with reduced surgical morbidity. Additionally, concomitant arthroscopic intervention may allow for intra-articular pathology to be addressed, which may further improve patient outcomes.

Indications for endoscopic gluteus medius and/or minimus repair include partial-thickness tearing, leading to significant pain and functional deficits that are recalcitrant to conservative management. While full-thickness and retracted tears may also be approached endoscopically, this technique may be particularly suited for cases with smaller tears and minimal fatty infiltration.

A standard anterolateral portal and a modified mid-anterior portal are established with fluoroscopic assistance. After intra-articular pathology is addressed, the greater trochanteric space is accessed. The torn tendon is identified and debrided, and the tendon footprint is exposed and prepared with a burr. The gluteal tendon is repaired to its attachment on the greater trochanter with suture anchors.

Endoscopic gluteus medius and/or minimus repair has demonstrated improvement in pain and function over short-term postoperative follow-up. An endoscopic approach may reduce the surgical morbidity relative to what is conferred by an open approach.

Gluteus medius and/or minimus tears may be effectively treated endoscopically. This approach may minimize surgical morbidity compared with an open approach and allows for concomitant treatment of intra-articular pathology.

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