To compare the outcome of open versus endoscopic gluteal tendon repair.
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.
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.
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.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Arthroscopy
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Frozen shoulder: Unravelling the enigma.Ann R Coll Surg Engl. 1997; 79: 210-213
- Trochanteric bursitis and tendinitis.Clin Orthop. 1961; 20: 193-202
- Prospective evaluation of magnetic resonance imaging and physical examination findings in patients with greater trochanteric pain syndrome.Arthritis Rheum. 2001; 44: 2138-2145
- MRI diagnosis of tears of the hip abductor tendons (gluteus medius and gluteus minimus).AJR Am J Roentgenol. 2004; 182: 137-143
- Tendinosis and tears of gluteus medius and minimus muscles as a cause of hip pain: MR imaging findings.AJR Am J Roentgenol. 1999; 173: 1123-1126
- Abductor tendon tears of the hip: Evaluation and management.J Am Acad Orthop Surg. 2011; 19: 385-391
- Rotator cuff tears of the hip.Clin Orthop Relat Res. 1999; : 135-140
- Gluteus medius tears: An under-diagnosed pathology.Br J Hosp Med (Lond). 2011; 72: 12-16
- Novel approaches for the management of tendinopathy.J Bone Joint Surg Am. 2010; 92: 2604-2613
- A biomechanical comparison of repair techniques for complete gluteus medius tears.Arthroscopy. 2012; 28: 1410-1416
- A mechanical comparison of gluteus medius attachment methods in a canine model.J Orthop Res. 1993; 11: 457-461
- Surgical repair of chronic tears of the hip abductor mechanism.Hip Int. 2009; 19: 372-376
- Surgical treatment of hip abductor tendon tears.J Bone Joint Surg Am. 2013; 95: 1420-1425
- Surgical repair of the gluteal tendons: A report of 72 cases.J Arthroplasty. 2011; 26: 1514-1519
- Endoscopic repair of full-thickness gluteus medius tears.Arthrosc Tech. 2013; 2: e77-e81
- Endoscopic repair of full-thickness abductor tendon tears: Surgical technique and outcome at minimum of 1-year follow-up.Arthroscopy. 2013; 29: 1941-1947
- Endoscopic repair of partial-thickness undersurface tears of the gluteus medius tendon.Orthop Traumatol Surg Res. 2013; 99: 853-857
- Endoscopic repair of gluteus medius tendon tears of the hip.Am J Sports Med. 2009; 37: 743-747
- Gluteus medius repair with double-row fixation.Arthrosc Tech. 2013; 2: e247-e250
- Prospective study of refractory greater trochanter pain syndrome. MRI findings of gluteal tendon tears seen at surgery. Clinical and MRI results of tendon repair.Joint Bone Spine. 2008; 75: 458-464
- Gluteal tendinopathy in refractory greater trochanter pain syndrome: Diagnostic value of two clinical tests.Arthritis Rheum. 2008; 59: 241-246
- Anatomy of the greater trochanteric ‘bald spot’: A potential portal for abductor sparing femoral nailing?.Clin Orthop Relat Res. 2008; 466: 2196-2200
- Anatomy and dimensions of the gluteus medius tendon insertion.Arthroscopy. 2008; 24: 130-136
Published online: May 29, 2015
Accepted: March 24, 2015
Received: January 6, 2015
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.
© 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.