Five-Year Outcomes of Endoscopic Gluteus Medius Repair Show Sustained Functional Improvement and High Clinically Relevant Threshold Achievement.

PURPOSE: To evaluate outcomes of endoscopic isolated gluteus medius (GM) repairs at minimum 5-year follow-up with a secondary comparison between short- and mid-term functional outcomes.

METHODS

Prospectively collected data were retrospectively analyzed for all patients who underwent endoscopic GM repairs between May 2009 and December 2018. Included patients had completed preoperative and minimum 5-year questionnaires for at least one patient-reported outcome (PRO) measure: the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), International Hip Outcome Tool (iHOT-12), Visual Analogue Scale (VAS), and patient satisfaction. Patients who were deceased or had revision surgeries were also included. The minimal clinically important difference (MCID) was calculated using a distribution-based method for all PROs and included in the analysis. A durability comparison between the mentioned PRO scores between 2- and 5-year postoperative was performed. Complications and secondary surgery were reported.

RESULTS

Of 31 eligible hips, 26 hips (83.87%) were included in this study and demonstrated significant mean improvements in all evaluated PROs (mHHS from 54.67 to 80.75, NAHS from 58.88 to 84.38, iHOT-12 from 32.96 to 72.16, and VAS from 5.85 to 2.93, P < .01), with high patient satisfaction reported. Moreover, a high percentage of patients had delta values that met MCID for mHHS (82.35%), NAHS (82.35%), and iHOT-12 (80.00%). Score improvements were sustained from 2 to 5 years across all PROs, with continued improvement in mHHS seen at the 5-year timepoint. Three hips (11.54%) underwent secondary surgery, all of which had full-thickness or high-grade partial-thickness (>50%) GM tear at the time of the primary endoscopic GM repair.

CONCLUSIONS

Endoscopic GM repairs yield significant improvement in functional PROs at 5-year minimum follow-up with a high percentage of patients meeting clinically relevant thresholds. Moreover, patients showed continued improvement over time, with score enhancements observed from 2 to 5 years postsurgery. An 88.46% revision-free survival rate was observed, with all revision endoscopies being females who had high-grade to full-thickness GM tears.

LEVEL OF EVIDENCE: Level IV, retrospective case series.