Short- to mid-term outcomes of gluteus maximus transfer for irreparable gluteus medius tears.

BACKGROUND

In cases of large, irreparable gluteus medius (GM) tears, gluteus maximus tendon transfer has emerged as a viable treatment option. The purpose of this study is to evaluate the short- to mid-term outcomes of gluteus maximus transfer as a treatment for irreparable GM tears in the native hip.

METHODS

Data was reviewed for all patients with native hips who underwent gluteus maximus transfer between 2011 and 2021. Patient were eligible for inclusion in the study if they presented with a full thickness irreparable GM tear treated with a gluteus maximus transfer and had completed preoperative and minimum 2-year postoperative questionnaires; or had a documented endpoint (revision surgery) within the study's timeframe. The minimal clinically important difference (MCID) for the mentioned PROs was calculated and included in the analysis.

RESULTS

A total of 15 native hips were included in the study, with all having a minimum 2-year follow-up and 8 reaching a minimum 5-year follow-up. The study group was predominantly female (93.3%), with a mean age of 66.7 ± 3.1 years, 3 (20%) patients underwent the gluteus maximus transfer as a primary surgery while 12 (80%) underwent a revision surgery from a prior failed GM repair. Significant improvements were observed across all evaluated patient reported outcome measures with high patient satisfaction. Additionally, only 3 patients (20%) showed a residual Trendelenburg gait, with 80% of patients regaining a normal gait. These improvements were sustained from the 2-year to the 5-year timepoint. A high percentage of patients reached the calculated MCID.

CONCLUSIONS

Gluteus maximus transfer remains a salvage procedure for irreparable GM tears. This procedure demonstrated favourable short- to mid-term outcomes, high patient satisfaction rates, high rate of restoration of normal gait, and a substantial percentage of patients achieving clinically meaningful improvements in functional scores.