A Comparison of Outcomes After Endoscopic Repair of Partial- Versus Full-Thickness Tears of the Gluteus Medius Tendon

Published:February 22, 2021DOI:


      The purpose of this study was to evaluate and compare the functional outcomes after endoscopic repair of partial or full-thickness gluteus medius tears at a minimum 2 years’ follow-up.


      Patients with isolated tears of the gluteus medius tendon repaired endoscopically between 2012 and 2017 were evaluated at a minimum 2 years of follow-up. Patients with large, retracted and/or irreducible tears, advanced atrophy, or fatty degeneration or with concomitant other hip pathology were excluded. Functional outcomes were assessed using the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), and visual analog scale (VAS) for pain preoperatively and at the last follow-up


      Forty-six patients, 3 men and 43 women with a mean (SD) age of 63 (9; range, 43-82) years, were included. Thirty-three patients (72%) had partial-thickness tears and 13 (28%) had full-thickness tears. Pain was reduced significantly from a median of 8 (IQR: 6-8) at the preoperative visit to a median of 2 (IQR: 15) at the most recent follow-up (P < .0001). The mHHS and NAHS improved significantly from a median of 44 (IQR: 35-52) to 80 (IQR: 64-87) (P < .0001) and 52 (IQR: 43-56) to 75 (IQR: 66-94) (P < .0001), respectively. These improvements were clinically relevant and surpass the reported minimal clinically important difference. Patients with partial tears had significant functional gains in the mHHS in comparison with patients with full-thickness tears (P = .02). No other statistically significant difference between groups of tear grade was observed.


      Endoscopic repair of gluteus medius tendon tears yields excellent functional outcomes at a minimum follow-up of 2 years. A lower functional improvement for full-thickness tears was observed; this difference was statistically significant for 1 of the 2 scores evaluated.

      Level of Evidence

      Level III, retrospective comparative cohort.
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        • Shbeeb M.I.
        • Matteson E.L.
        Trochanteric bursitis (greater trochanter pain syndrome).
        Mayo Clin Proc. 1996; 71: 565-569
        • Strauss E.J.
        • Nho S.J.
        • Kelly B.T.
        Greater trochanteric pain syndrome.
        Sports Med Arthrosc Rev. 2010; 18: 113-119
        • Lachiewicz P.F.
        Abductor tendon tears of the hip: Evaluation and management.
        J Am Acad Orthop Surg. 2011; 19: 385-391
        • Lequesne M.
        • Djian P.
        • Vuillemin V.
        • Mathieu P.
        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
        • Lequesne M.
        • Mathieu P.
        • Vuillemin-Bodaghi V.
        • Bard H.
        • Djian P.
        Gluteal tendinopathy in refractory greater trochanter pain syndrome: Diagnostic value of two clinical tests.
        Arthritis Rheum. 2008; 59: 241-246
        • Lequesne M.
        From “periarthritis” to hip “rotator cuff” tears: Trochanteric tendinobursitis.
        Joint Bone Spine. 2006; 73: 344-348
        • Davies H.
        • Zhaeentan S.
        • Tavakkolizadeh A.
        • Janes G.
        Surgical repair of chronic tears of the hip abductor mechanism.
        Hip Int. 2009; 19: 372-376
        • Davies J.F.
        • Stiehl J.B.
        • Davies J.A.
        • Geiger P.B.
        Surgical treatment of hip abductor tendon tears.
        J Bone Joint Surg Am. 2013; 95: 1420-1425
        • Walsh M.J.
        • Walton J.R.
        • Walsh N.A.
        Surgical repair of the gluteal tendons: A report of 72 cases.
        J Arthroplasty. 2011; 26: 1514-1519
        • Schröder J.H.
        • Geßlein M.
        • Schütz M.
        • Perka C.
        • Krüger D.
        Open repair of gluteus medius and minimus tendons tears with double-row technique: Clinical and radiological results [in German].
        Orthopade. 2018; 47: 238-245
        • Yanke A.B.
        • Hart M.A.
        • McCormick F.
        • Nho S.J.
        Endoscopic repair of a gluteus medius tear at the musculotendinous junction.
        Arthrosc Tech. 2013; 2: e69-e72
        • Domb B.G.
        • Carreira D.S.
        Endoscopic repair of full-thickness gluteus medius tears.
        Arthrosc Tech. 2013; 2: e77-e81
        • Byrd J.W.T.
        Gluteus medius repair with double-row fixation.
        Arthrosc Tech. 2013; 2: e247-e250
        • Levy D.M.
        • Bogunovic L.
        • Grzybowski J.S.
        • Kuhns B.D.
        • Bush-Joseph C.A.
        • Nho S.J.
        All-endoscopic single-row repair of full-thickness gluteus medius tears.
        Arthrosc Tech. 2016; 5: e1-e6
        • Alpaugh K.
        • Chilelli B.J.
        • Xu S.
        • Martin S.D.
        Outcomes after primary open or endoscopic abductor tendon repair in the hip: A systematic review of the literature.
        Arthroscopy. 2015; 31: 530-540
        • LaPorte C.
        • Vasaris M.
        • Gossett L.
        • Boykin R.
        • Menge T.
        Gluteus medius tears of the hip: A comprehensive approach.
        Phys Sportsmed. 2019; 47: 15-20
        • Chandrasekaran S.
        • Lodhia P.
        • Gui C.
        • Vemula S.P.
        • Martin T.J.
        • Domb B.G.
        Outcomes of open versus endoscopic repair of abductor muscle tears of the hip: A systematic review.
        Arthroscopy. 2015; 31: 2057-2067.e2
        • Byrd J.W.T.
        • Jones K.S.
        Endoscopic repair of hip abductor tears: outcomes with two-year follow-up.
        J Hip Preserv Surg. 2017; 4: 80-84
        • Cvitanic O.
        • Henzie G.
        • Skezas N.
        • Lyons J.
        • Minter J.
        MRI diagnosis of tears of the hip abductor tendons (gluteus medius and gluteus minimus).
        AJR Am J Roentgenol. 2004; 182: 137-143
        • Thaunat M.
        • Clowez G.
        • Desseaux A.
        • et al.
        Influence of muscle fatty degeneration on functional outcomes after endoscopic gluteus medius repair.
        Arthroscopy. 2018; 34: 1816-1824
        • Harris W.H.
        Traumatic arthritis of the hip after dislocation and acetabular fractures: Treatment by mold arthroplasty. An end-result study using a new method of result evaluation.
        J Bone Joint Surg Am. 1969; 51: 737-755
        • Christensen C.P.
        • Althausen P.L.
        • Mittleman M.A.
        • Lee J.
        • McCarthy J.C.
        The nonarthritic hip score: reliable and validated.
        Clin Orthop Relat Res. 2003; : 75-83
        • Domb B.G.
        • Botser I.
        • Giordano B.D.
        Outcomes of endoscopic gluteus medius repair with minimum 2-year follow-up.
        Am J Sports Med. 2013; 41: 988-997
        • Voos J.E.
        • Shindle M.K.
        • Pruett A.
        • Asnis P.D.
        • Kelly B.T.
        Endoscopic repair of gluteus medius tendon tears of the hip.
        Am J Sports Med. 2009; 37: 743-747
        • Okoroha K.R.
        • Beck E.C.
        • Nwachukwu B.U.
        • Kunze K.N.
        • Nho S.J.
        Defining minimal clinically important difference and patient acceptable symptom state after isolated endoscopic gluteus medius repair.
        Am J Sports Med. 2019; 47: 3141-3147
        • Harris J.D.
        • Brand J.C.
        • Cote M.P.
        • Faucett S.C.
        • Dhawan A.
        Research pearls: The significance of statistics and perils of pooling. Part 1: Clinical versus statistical significance.
        Arthroscopy. 2017; 33: 1102-1112
        • McCormick F.
        • Alpaugh K.
        • Nwachukwu B.U.
        • Yanke A.B.
        • Martin S.D.
        Endoscopic repair of full-thickness abductor tendon tears: Surgical technique and outcome at minimum of 1-year follow-up.
        Arthroscopy. 2013; 29: 1941-1947
        • Chandrasekaran S.
        • Gui C.
        • Hutchinson M.R.
        • Lodhia P.
        • Suarez-Ahedo C.
        • Domb B.G.
        Outcomes of endoscopic gluteus medius repair: Study of thirty-four patients with minimum two-year follow-up.
        J Bone Joint Surg Am. 2015; 97: 1340-1347
        • Hartigan D.E.
        • Perets I.
        • Ho S.W.
        • Walsh J.P.
        • Yuen L.C.
        • Domb B.G.
        Endoscopic repair of partial-thickness undersurface tears of the abductor tendon: Clinical outcomes with minimum 2-year follow-up.
        Arthroscopy. 2018; 34: 1193-1199
        • Perets I.
        • Mansor Y.
        • Yuen L.C.
        • Chen A.W.
        • Chaharbakhshi E.O.
        • Domb B.G.
        Endoscopic gluteus medius repair with concomitant arthroscopy for labral tears: A case series with minimum 5-year outcomes.
        Arthroscopy. 2017; 33: 2159-2167
        • Downie W.W.
        • Leatham P.A.
        • Rhind V.M.
        • Wright V.
        • Branco J.A.
        • Anderson J.A.
        Studies with pain rating scales.
        Ann Rheum Dis. 1978; 37: 378-381