A Comparative Outcomes Study: Is Routine Hip Abduction Bracing Necessary After Gluteus Medius Repair?

Introduction Postoperative protocols regarding hip bracing after the surgical repair of a gluteus medius tear remain variable. It is unclear whether hip bracing improves short-term outcomes in patients undergoing gluteus medius repair. The purpose of this study was to evaluate the combined six-month complication and reoperation rate before and after discontinuing postoperative hip brace use after a gluteus medius repair. Methods A retrospective review of 162 patients undergoing gluteus medius repair by a single, fellowship-trained surgeon was performed. The no-brace protocol was implemented in October 2020. Prior to October 2020, all patients were prescribed a postoperative brace, and this served as the historical control group. Starting in October 2020, the postoperative brace was no longer prescribed, and this served as the study group. The remainder of the perioperative protocol was the same for both groups. All patients immediately began physical therapy and had toe-touch weightbearing restrictions for three weeks postoperatively. The primary endpoint was the combined complication and reoperation rate within six months postoperatively. Results The groups were similar demographically, with the only significant difference being that the no-brace group had a higher percentage of patients undergo open repair (29 (33.7%) vs. 14 (18.4%); p=0.028). There were no significant differences in outcomes at 30 days when looking at emergency department returns (2 (2.3%) vs. 4 (5.3%); p=0.421) and readmissions (0% vs. 2 (2.6%); p=0.219). At six weeks, there were no significant differences in falls (2 (2.3%) vs. 1 (1.3%); p=1.000) and other complications (1 (1.2%) vs. 2 (2.6%); p=0.601). Similarly, at six months, there were no significant differences in falls (4 (4.7%) vs. 1 (1.3%); p=0.372) and other complications including deep vein thrombosis, re-tear, fibromyalgia flare, and fracture (5 (5.8%) vs. 5 (6.6%); p=0.840). There was also no significant difference between groups in reoperation rates within six months (0% vs. 2 (2.6%); p=0.219). The combined six-month complication and reoperation rate was also not significant between groups (10 (11.6%) vs. 9 (11.8%); p=0.966). Conclusion In patients undergoing gluteus medius repair, postoperative bracing was not associated with differences in complication rates over the six-month postoperative period. Based on this result, discontinuation of postoperative bracing appears safe in this population. Further study is needed to replicate these results with a larger sample size.