Patients who experience persistent hip pain after nonoperative treatments for partial or full-thickness gluteus medius tears have two surgical repair options: open or endoscopic. A two-year follow up study by Chandrasekaran et al. in the August 19, 2015 edition of The Journal of Bone & Joint Surgery found that endoscopic repair with correction of identified intra-articular pathology yielded substantial postprocedure functional improvements and pain reduction, along with high levels of overall patient satisfaction. In addition, 15 of the 26 patients who had preoperative gait deviations were found to have a completely normal gait at the two-year follow up. No postoperative complications or re-tears were reported.
The study followed 34 patients (predominantly women, mean age of 57 years) who had endoscopic repairs. Seventeen (50%) of the patients with full-thickness or near full-thickness tears were treated with a suture bridge technique, while the 17 with partial-thickness tears received a transtendinous repair. There was no significant difference in patient-reported outcome measures between the two surgical techniques.
The ability to address intra-articular pathology is touted as an advantage of the endoscopic approach, and in this study concomitant procedures included capsule release, labral debridement and repair, and acetabuloplasty.
Although the Chandrasekaran et al. study did not compare outcomes of endoscopic versus open repair, it did track the largest reported number of endoscopy patients for the longest reported duration.