When an MRI or MR arthrogram of the hip documents a labral tear and a gluteus medius tendon (GMT) tear in a patient with hip pain, a question that arises is what should be done about the GMT tear. Arthroscopic repair of GMT tears has been advocated as an adjunct to hip arthroscopy for the treatment of hip pain. To date, the indications for this procedure and the outcomes of patients who have had hip arthroscopy without repair of their GMT tears have not been delineated. This study compares the results of 30 patients with and 30 patients without GMT tears who at the time of their hip arthroscopy only had treatment of their intra-articular lesions.
Material and Methods
For this study, the preoperative magnetic resonance arthrograms (MRA's) of 150 patients who had their imaging completed at our institution and their hip arthroscopy performed by the senior author, were reviewed by two musculoskeletal radiologists who were specifically looking for gluteus medius tendon (GMT) tears. From this review, 6 patients with partial-thickness and 24 patients with full-thickness GMT tears (0.5 to 3.7 cm in length) were identified. The results of hip arthroscopy in these patients were compared to those of 30 demographically-matched patients that were selected from the remaining 120 patients that did not have GMT tears. All 60 hips included in this study were examined by the senior author and assessed with Byrd's 100-point modified Harris hip scoring system prior to arthroscopy, and at 3, 6, and 12 months after surgery.
The average age of the 30 patients with tendon tears (GMT patients) and the 30 patients without tears (GWT patients) was 44 and 42 years, and their preoperative scores averaged 41 and 46 points, respectively. Prior to surgery, all 60 patients had anterior hip pain with prolonged sitting and with twisting activities, and 20 patients (10 in each group) had pain and tenderness at the greater trochanter. By three months after surgery, the average hip scores for the GMT and GWT patients were 85 and 88 points, respectively. At six months, the scores averaged 88 and 89 points, and after 12 months, the scores averaged 90 and 91 points, repectively. At all of the follow-up intervals, there were no significant differences between the scores of the two groups (p>0.05).
Gluteus medius tendon tears that were evident on preoperative MRA's did not affect the outcomes of patients who at the time of their hip arthroscopy only had treatment of their intra-articular lesions.
© 2012 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.