Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original ArticleAssessment of Association Between Spino-Pelvic Parameters and Outcomes Following Gluteus Medius Repair
Section snippets
Patient Selection
Following institutional review board approval (no. 16091507-IRB02), patients aged 18 to 80 years who underwent repair of the gluteus medius, minimus, or both tendons with a single, fellowship-trained surgeon (S.J.N.) between January 20, 2012, and November 25, 2015, with a minimum 22-month clinical follow-up were retrospectively identified from a database of prospectively collected data. Exclusion criteria included patients who lived out of state and were not able to travel to our institution
Demographics
Forty-seven patients who underwent gluteus medius or minimus repair >22 months after surgery were identified from the senior surgeon's surgical repository and met exclusion criteria. Thirty-eight (80.9%) of those patients agreed to be radiographically evaluated with a scoliosis series, and those patients were included in the analysis. The characteristics of patients who were radiographically evaluated were similar to the patients in the whole sample (Tables 1 and 2). Thirty two patients (84.2%)
Discussion
The results of this study suggest that nearly half (47%) of patients with gluteus medius tear in this study have a radiographically defined adult scoliosis, and most patients (55%) had these tears on the concave side of the major curve. The concavity of the major curve was not associated with significantly different outcomes after a surgical repair of the gluteus medius/minimus. However, patients with scoliosis (Cobb angle >10°) had significantly lower postoperative iHOT-12 scores than their
Conclusions
Patients with scoliosis presented with lower symptoms improvements, and ability to return to an active lifestyle in patients with hip disorders. In addition, patients with positive sagittal plane deformity experienced lower hip-related sport-specific outcome scores. Although the direct relationship between the spine and the hip in patients after gluteus medius/minimus repair remain unclear, this study shows an association between these postoperative outcomes and spinopelvic parameters.
References (32)
- et al.
Partial-thickness tears of the gluteus medius: Rationale and technique for trans-tendinous endoscopic repair
Arthroscopy
(2010) - et al.
Clinical and MRI results in 67 patients operated for gluteus medius and minimus tendon tears with a median follow-up of 4.6 years
Orthop Traumatol Surg Res
(2014) - et al.
Total hip arthroplasty in the spinal deformity population: Does degree of sagittal deformity affect rates of safe zone placement, instability, or revision?
J Arthroplasty
(2017) - et al.
The effect of platelet-rich fibrin matrix at the time of gluteus medius repair: A retrospective comparative study
Arthroscopy
(2018) - et al.
Prior lumbar spinal fusion is associated with an increased risk of dislocation and revision in total hip arthroplasty: A meta-analysis
J Arthroplasty
(2018) - et al.
Influence of cuff muscle fatty degeneration on anatomic and functional outcomes after simple suture of full-thickness tears
J Shoulder Elbow Surg
(2003) - et al.
Application of the Goutallier/Fuchs rotator cuff classification to the evaluation of hip abductor tendon tears and the clinical correlation with outcome after repair
Arthroscopy
(2015) - et al.
All-endoscopic single-row repair of full-thickness gluteus medius tears
Arthrosc Tech
(2016) - et al.
The impact of spino-pelvic alignment on total hip arthroplasty outcomes: A critical analysis of current evidence
J Arthroplasty
(2018) - et al.
Abnormally high dislocation rates of total hip arthroplasty after spinal deformity surgery
J Arthroplasty
(2016)
Femoroacetabular impingement and pelvic incidence: Radiographic comparison to an asymptomatic control
Arthroscopy
Outcomes of open versus endoscopic repair of abductor muscle tears of the hip: A systematic review
Arthroscopy
Tendinosis and tears of gluteus medius and minimus muscles as a cause of hip pain: MR imaging findings
AJR Am J Roentgenol
Abductor tendon tears of the hip: Evaluation and management
J Am Acad Orthop Surg
Clinical presentation and imaging results of patients with symptomatic gluteus medius tears
J Hip Preserv Surg
Rotator cuff tears of the hip
Clin Orthop Relat Res
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Patients with operative gluteus medius tears often present with a concomitant history of lumbar pathology
2024, Journal of OrthopaedicsThe Gluteus Medius Experiences Significant Excursion With Hip Flexion
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2023, Arthroscopy, Sports Medicine, and RehabilitationCitation Excerpt :When we examined spinopelvic parameters (PT, SS, PI, LL, PI-LL, T9-spinopelvic inclination, sagittal vertical axis [SVA], T1-pelvic angle) in 107 patients with evidence of sagittal spinal deformity following THA using stereoradiographic EOS, DelSole et al.16 reported a high dislocation rate (8%), with patients suffering dislocation possessing significantly greater spinopelvic tilt and PI-LL mismatch. Meanwhile, when evaluating spinopelvic parameters on outcomes in 38 patients at a minimum of 22 months following gluteus medius/minimus repair, Saltzman et al.41 reported that patients with a positive sagittal vertical axis (SVA > 0 cm) reported significantly worse HOS-ADL (P = .026) and HOS-SS (P = .011) when compared with patients with a SVA <0 cm. As such, although the relationship between the spine and the hip in patients undergoing various hip procedures has been established, further investigations are warranted to better understand the influence of spinopelvic mechanics and anatomy using additional spinopelvic parameters and advanced imaging modalities (i.e., computed tomography [CT], magnetic resonance imaging [MRI]) on outcomes following hip arthroscopy for FAIS.
Hip Abductor and Peritrochanteric Space Conditions
2021, Clinics in Sports MedicineCitation Excerpt :Physical examination findings including tenderness to palpation of the greater trochanter, decreased abduction strength, and abductor atrophy may be notable.30 Patients may also walk with an antalgic and/or Trendelenburg gait.21,31 The most commonly used imaging includes plain radiographs, ultrasonography, and MRI.2,32
Hip Gluteus Medius and Minimus Endoscopic Treatment Results in Patient Satisfaction
2020, Arthroscopy - Journal of Arthroscopic and Related SurgeryEditorial Commentary: On Mentors and “Peeling Onions”: Scoliosis Results in Inferior Outcomes Following Hip Gluteus Medius Tendon Repair
2019, Arthroscopy - Journal of Arthroscopic and Related Surgery
See commentary on page 1099
The authors report the following potential conflicts of interest or sources of funding: S.N. receives research support from Allosource Arthrex,Inc, Athletico, DJ Orthopaedics, Linvatec, Miomed, Smith and Nephew, and Stryker; is a member of the editorial/governing board of the American Journal of Orthopedics; is a board/committee member of the American Society for Sports Medicine and the Arthroscopy Association of North America; is a paid consultant for Ossur; receives IP royalties from Ossur; receives publishing royalties from Springer; and receives financial/material support from Springer. Full ICMJE author disclosure forms are available for this article online, as supplementary material.