Mid-term outcomes of endoscopic gluteus medius repair with concomitant arthroscopic labral treatment: a propensity-matched controlled study

Purpose: The purpose of this study was to report mid-term outcomes of patients who underwent endoscopic gluteus medius (GM) repair with arthroscopic labral treatment and to compare them to a control cohort of patients who underwent arthroscopic labral treatment without an endoscopic GM repair.

Methods: Data were prospectively collected and retrospectively reviewed for all patients who underwent primary hip arthroscopy between February 2008 and August 2013. Patients were included if they underwent arthroscopic labral treatment, endoscopic GM repair, and had preoperative with minimum 5-year follow-up for the following PROs: modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), and Hip Outcome Score-Sports Specific Subscale (HOS-SSS). Propensity score matching was used to create a control cohort of patients who underwent primary arthroscopic labral treatment without GM repair.

Results: There were a total of 46 patients with GM repair eligible for the current study, of which 43 (93.5%) had 5-year follow-up. The average follow-up time was 73.4 months. At minimum 5-year follow-up, all PROs significantly improved (p < 0.001). Among the entire GM repair cohort, rates for achieving the patient acceptable symptomatic state (PASS) for mHHS, HOS-SSS, and international Hip Outcome Tool (iHOT-12) were 74.4%, 51.9%, and 71.8%, respectively. Rates for reaching a minimal clinically important difference (MCID) for mHHS, NAHS, and HOS-SSS were 79.5%, 89.7%, and 73.1%, respectively. When the GM repair cohort was matched, there were 37 cases in the GM repair cohort and 78 in the control cohort. The GM repair cohort outcomes compared satisfactorily to the control cohort for mHHS (82.3 vs. 82.6), NAHS (81.9 vs. 82.3), and HOS-SSS (66.3 vs. 67.5). Rates of MCID and PASS for mHHS, NAHS, HOS-SSS, and iHOT-12 were also favorable.

Conclusion: Endoscopic GM repair with arthroscopic labral treatment results in safe, durable, and significant improvement in PROs at a minimum 5-year follow-up. The outcomes compared favorably to a control cohort without GM tears.