Endoscopic Repair of Full-Thickness Gluteus Medius and Minimus Tears-Prospective Study with a Minimum 2-Year Follow-up


The purpose of this study is to evaluate the short-term outcomes of endoscopic repair of full-thickness gluteus medius and minimus tendon tears with a minimum of 2-year follow-up and add to the paucity of literature on abductor tendon tears.


All patients who underwent endoscopic abductor tendon repair between December 2013 and August 2017 were prospectively evaluated. The inclusion criteria for this study were primary full-thickness gluteal tendon tears and at least 2-years follow-up. Clinical outcome data consisted of VAS pain score, hip abduction strength, Trendelenburg sign, complications, and patient reported outcome measures (PROMs): modified Harris Hip Score, Hip Outcome Score, Non-arthritic Hip Scale, International Hip Outcome Tool, and Lower Extremity Functional Scale.


A total of 15 hips, all full-thickness tears, met inclusion criteria with an average follow-up of 31.2 months, with no patients being excluded. On physical exam, there was a significant improvement in VAS pain score from 5.36 to 2.43 (p-value = .0243), hip abduction strength with 8 (53.3%) hips improving by at least 1 point (p-value = .02056), and resolution of Trendelenburg sign in all 15 hips at 2-years (p-value = .0019). The mean difference for all 6 PROMs was statistically significant, even after Bonferroni adjustment, with the majority of patient improvement exceeding the minimal clinically important difference (MCID) thresholds: mHHS: 86.67%, HOS-ADL: 86.67%, HOS-SSS: 66.67%, NAHS: 93.33%, and iHOT-33: 80%. Higher Goutallier grade was associated with a higher VAS pain score. There were no complications, including no re-tears.


In this study of 15 hips with full-thickness gluteal tendon tears managed endoscopically, we found excellent outcomes that exceeded the MCID thresholds in the majority of patients at an average of 31.2 months follow-up, while offering the potential advantages of less tissue violation, ambulatory day surgery, and fewer complications compared to open repair.