Differences in Clinical Presentations and Surgical Outcomes of Gluteus Medius Tears Between Men and Women

Background: Gluteus medius (GM) tears often occur in women aged >50 years. There is a paucity of literature comparing sex-based differences in those undergoing GM repair.

Purpose: To report differences between women and men in clinical presentations and patient-reported outcome (PRO) scores at a minimum 2-year follow-up after undergoing GM repair.

Study design: Cohort study; Level of evidence, 3.

Methods: Data were prospectively collected and retrospectively reviewed. All included patients had postoperative scores for the following PROs: modified Harris Hip Score (mHHS), Non-arthritic Hip Score (NAHS), Hip Outcome Score-Sports Specific Subscale (HOS-SSS), and International Hip Outcome Tool-12. Men were propensity score matched 1:3 to women according to concomitant arthroscopic procedures and follow-up time. Clinical effectiveness was determined through a uniquely calculated minimal clinically important difference (MCID) for the mHHS and NAHS specific to this study population.

Results: Thirteen men were successfully propensity score matched to 39 women. Women and men were 55.87 ± 11.0 and 62.38 ± 11.63 years old (mean ± SD), respectively (P = .02). Men were at increased risk for associated lumbar pathology as compared with women (relative risk, 3.32; P = .02). Women showed significant improvement from preoperative to minimum 2-year follow-up for the mHHS (59.32 ± 15.36 to 83.81 ± 16.82; P < .01), NAHS (56.23 ± 15.61 to 83.78 ± 17.66; P < .01), HOS-SSS (33.35 ± 20.28 to 67.88 ± 32.35; P < .01), and visual analog scale (5.48 ± 2.00 to 1.93 ± 2.29; P < .01). Similarly, men showed significant improvement for the mHHS (63.50 ± 16.41 to 84.77 ± 13.91; P < .01), NAHS (61.52 ± 9.87 to 84.42 ± 14.87; P < .01), HOS-SSS (33.97 ± 21.20 to 63.62 ± 26.20; P < .01), and visual analog scale (4.93 ± 2.69 to 1.86 ± 2.10; P < .01). The MCIDs for the mHHS and NAHS were calculated to be 7.89 and 7.24. Of the women, 28 (72%) and 34 (87%) met the MCID for the mHHS and NAHS. Eleven (85%) men met the MCID for the mHHS and NAHS.

Conclusion: These results suggest that women and men can both benefit after GM repair. Men were older and had increased risk for associated lumbar pathology than women at the time of surgery. Men and women both experienced significant improvements in PROs and compared favorably in terms of clinical effectiveness at a minimum 2-year follow-up.

Keywords: gender; gluteus medius; hip arthroscopy; hip endoscopy.