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Both open and endoscopic gluteal tendon repairs lead to functional improvement with similar failure rates: a systematic review
  1. Robert Longstaffe1,
  2. Patrick Dickerson2,
  3. Charles A Thigpen2,3,
  4. Ellen Shanley2,3,
  5. Michael J Kissenberth2,
  6. Jason Folk2,
  7. Stephan G Pill2
  1. 1University of Manitoba Department of Surgery, Section Orthopaedics, Pan Am Clinic, Winnipeg, Manitoba, Canada
  2. 2Prisma Health Steadman Hawkins Clinic of the Carolinas, Greenville, South Carolina, USA
  3. 3ATI Physical Therapy, Greenville, South Carolina, USA
  1. Correspondence to Dr Robert Longstaffe, Pan Am Clinic, Winnipeg, R3M 3E4, Canada; r.c.longstaffe{at}gmail.com

Abstract

Importance Operative treatment of gluteal tendon tears is becomingly increasingly more common with varying surgical techniques and rehabilitation protocols.

Objective To perform a systematic review of gluteal tendon repair as it relates to tear characteristics, rehabilitation protocols, patient-reported outcomes, satisfaction, resolution of gait deviation and complication rates.

Evidence review A comprehensive literature search of PubMed and Embase/MEDLINE was used to identify all literature pertaining to gluteal tendon repair. A total of 389 articles were identified.

Findings A total of 22 studies (611 hips) were included in this review. The majority of tears were noted to be partial thickness (77.9% vs 22.1%). Both arthroscopic and open repair demonstrated improvements in functional outcomes. Within studies documenting gait deviation, 54% were noted to have gait deviation preoperatively, of which approximately 70% had resolution following repair. On average, abduction strength increased almost one whole grade (0.84) following repair. Overall complication rate was found to be 5.2% (20 of 388 hips). Endoscopic repair demonstrated a decreased complication rate compared with open (0.7% vs 7.8%). Retear rate was found to be 3.8%, with open repair having a slightly increased rate compared with endoscopic repair (3.4% vs 4.1%).

Conclusions and relevance The majority of tears tend to be partial thickness with involvement of gluteus medius in almost all cases and concomitant involvement of gluteus minimus in close to half of cases. Both endoscopic and open gluteal tendon repairs resulted in improvements in outcomes and functional improvement. Retear rates were similar between the two repair techniques, while endoscopic repair demonstrated a lower complication rate.

Level of evidence Level IV, systematic review.

  • hip
  • tears
  • orthopedic procedures
  • tendons
  • endoscopy
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Footnotes

  • Contributors RL: lead author was involved in all aspects of this manuscript from study conception and design, literature review, data abstraction and analysis, and primary manuscript writer. PD was involved in study design, literature review and data abstraction and analysis. CT and ES were involved data abstraction and analysis. MK, JF and SP were involved in study conception and design and critical review and revision of the study manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval As this was a systematic review, study ethics approval was not required prior to commencement of literature review.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. The complete breakdown of all included studies is found in appendix table 1 as supplementary data.

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