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Equivalent Patient-Reported Outcomes for Suture Staple Technique Versus Control Side-To-Side Endoscopic Gluteus
Vasileios Giovanoulis1,2,3, Christos Koutserimpas4,5, Fabricio Luciano Vassallo6
1Ramsay Santé, Hôpital privé Jean Mermoz, Centre Orthopédique Santy, FIFA Medical Center of Excellence, Lyon, France.
Purpose:
To compare outcomes of endoscopic gluteus medius repair using the suture staple technique versus a control side-to-side repair at ≥24-month follow-up.
Methods:
A retrospective, single-center study from January 2015 to December 2021 was conducted with data collected during a transitional period where evolving surgical practices led to the adoption of the suture staple technique. Included were all patients with ≥2 years of follow-up and ≥6 months of well-structured nonoperative treatment. Outcomes were assessed using the modified Harris Hip Score, Victorian Institute of Sport Assessment - Gluteal, and visual analog scale. Statistical analyses included Student's t-test and Wilcoxon test for comparing group differences, with significance set at P < .05.
Results:
Sixty-one patients were analyzed (control n = 31; suture staple n = 30). The overall mean age was 65.7 (standard deviation [SD] = 10.4 years); control (65.2 SD = 10.7 years), and suture stable group (66.1, SD 10.3 years). The cohort was predominantly female (78.7%), including 80.6% women in the control group and 76.7% in the suture stable group. Follow-up averaged 72.7 months (SD 34.4; range 24-142). Follow-up was significantly longer in the control side-to-side group than in the suture staple group (mean 82.8 SD 31.6 vs 62.3 SD 34.6 months; P = .0180). The modified Harris Hip Score increased from 32.7 (SD 19.1) preoperatively to 71.0 (SD 18.2) postoperatively, with no significant difference between groups (P = .5322). Victorian Institute of Sport Assessment - Gluteal improved by 40.2 units (SD 22.6), with 85.2% achieving the minimal clinically important difference of 11.3 (P = .4635). Visual analog scale scores decreased from 7.7 (SD 2.1) to 2.7 (SD 2.0), with 90.2% achieving the minimal clinically important difference of 1.3 with no significant difference (P = .1058). Sex-disaggregated analyses revealed no significant between-technique differences in men or women for modified Harris Hip Score, Victorian Institute of Sport Assessment - Gluteal, or visual analog scale (men: P = .9318, .4400, and .4276; women: P = .4288, .7501, and .2101, respectively). Both techniques provided comparable functional and pain relief outcomes.
Conclusion:
The suture staple technique and side-to-side technique are effective for endoscopic gluteus medius tendon repair, achieving significant functional and pain score improvements over a mean follow-up of 6 years.
Level Of Evidence:
Level III, retrospective comparative cohort.
