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

Abstract

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. 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. 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. 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 IV, retrospective case series.