Improved Outcomes in Hip Abductor Tendon Repairs With Augmentation and Gluteus Maximus Transfer: A Systematic Review

To review available research on hip abductor repairs using augmentation or gluteus maximus transfer, focusing on improvement in patient-reported outcomes from preoperation.

A literature search was conducted in PubMed, Embase, ClinicalTrials.gov, and Cochrane from inception to December 11, 2024. Studies showing patients with symptomatic partial or full hip abductor tears and surgical repair with augmentation or gluteus maximus transfer were included. Extracted data contained patient demographics, augmentation type, surgical technique, study characteristics, and pre- and postoperational patient-reported outcomes.

A total of 6 studies (261 patients) were included. Mean differences in visual analog scale for pain score, modified Harris Hip Score, and Hip Outcome Score-Activities of Daily Living were reported. Mean differences ranged from -6.6 to -3.5 for visual analog scale for pain, 21.3 to 44.0 for modified Harris Hip Score, and 24.1 to 33.9 for Hip Outcome Score-Activities of Daily Living. Two of the 6 included studies reported patient-level metrics for clinically meaningful improvement reported as minimal clinically important difference/patient acceptable symptomatic state/substantial clinical benefit achievement.

In studies reporting patient outcomes after hip abductor tendon repair with augmentation and gluteus maximus transfer, patients report improved postoperative outcomes at midterm follow-up. The proportion of patients with minimal clinically important difference, patient acceptable symptomatic state, and substantial clinical benefit achievement ranged across reported outcomes from 57.9% to 100.0%, 44.7% to 52.6%, and 31.6% to 34.2%, respectively; however, reporting of these metrics proved inconsistent across included studies.

Level IV, systematic review of Level III and IV studies.