Purpose
To compare the outcome of open versus endoscopic gluteal tendon repair.
Methods
An extensive review of PubMed was conducted by 2 independent reviewers for articles
containing at least 1 of the following search terms: gluteus medius, gluteus medius
tear, gluteus medius tendinopathy, gluteus medius repair, hip abductors, hip abductor
tears, hip abductor repair, hip rotator cuff, hip rotator cuff repair, trochanteric
bursa, trochanteric bursitis, trochanteric bursectomy, peritrochanteric procedures,
peritrochanteric repair, and peritrochanteric arthroscopy. This yielded 313 articles.
Of these articles, 7 satisfied the following inclusion criteria: description of an
open or endoscopic gluteal repair with outcomes consisting of patient-reported outcome
scores, patient satisfaction, strength scores, pain scores, and complications.
Results
Three studies on open gluteal repairs and 4 on endoscopic gluteal repairs met the
inclusion criteria. In total, there were 127 patients who underwent open procedures
and 40 patients who underwent endoscopic procedures. Of the 40 patients who underwent
endoscopic procedures, 15 had concomitant intra-articular procedures documented, as
compared with 0 in the open group. The modified Harris Hip Score was common to 1 study
on open repairs and 3 studies on endoscopic repairs. The scores were similar for follow-up
periods of 1 and 2 years. Visual analog pain scale scores were reported in 1 study
on open gluteal repairs and 1 study on endoscopic repairs and were similar between
the 2 studies. Improvement in abductor strength was also similarly reported in selected
studies between the 2 groups. The only difference between the 2 groups was the reported
incidence of complications, which was higher in the open group.
Conclusions
Open and endoscopic gluteal repairs have similar patient-reported outcome scores,
pain scores, and improvement in abduction strength. Open techniques have a higher
reported complication rate. Randomized studies of sufficient numbers of patients are
required to ultimately determine if one technique produces superior patient outcomes
over the other.
Level of Evidence
Level IV, systematic review of Level IV studies.
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Article info
Publication history
Published online: May 29, 2015
Accepted:
March 24,
2015
Received:
January 6,
2015
Footnotes
See commentary on page 2068
The authors report the following potential conflict of interest or source of funding: B.G.D. receives support from Arthrex, MAKO Surgical, Pacira, Breg, and ATI. B.G.D owns stock inStryker and receives royalties from Orthomerica and DJO Global.
Identification
Copyright
© 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
