Hinsdale Orthopaedics, Hinsdale, IL, USA.
Am J Sports Med. 2013 May;41(5):988-97. doi: 10.1177/0363546513481575. Epub 2013 Mar 22.
Gluteus medius tears may be present in as many as 25% of late middle-aged women and 10% of middle-aged men, and they are often misdiagnosed. Outcomes of endoscopic repair of gluteus medius tears have seldom been reported.
To report the early outcomes of endoscopic repair of partial- and full-thickness gluteus medius tears.
Case series; Level of evidence, 4.
Between April 2009 and January 2010, data were prospectively collected for all patients undergoing endoscopic gluteus medius repair by one of the authors. Inclusion criteria for the study were patients undergoing repair for either high-grade, partial-, or full-thickness tears. Only patients with endoscopic evidence of a gluteus medius tear were treated surgically. In the case of an articular-side tear, a transtendinous repair technique was used, whereas in the presence of a full-thickness tear, the tendon was refixated to the bone directly.
A total of 15 patients met the inclusion criteria. The cohort included 14 women and 1 man, with an average age of 58 years (range, 44-74 years). Endoscopically, 6 cases were found to be partial-thickness tears. Nine were either full-thickness tears or near-full-thickness tears, which were completed for the repair. Follow-up was obtained on all patients at an average of 27.9 months postoperatively (range, 24-37 months). Fourteen of the 15 patients showed postoperative improvement in all 4 hip-specific scores used to assess outcome, with an average improvement of more than 30 points for all scores. Satisfaction with the surgery results was reported to be from good to excellent (scores of 7-10 out of 10) in 14 of 15 patients.
This study demonstrates that endoscopic surgical repair, whether performed through a transtendinous or full-thickness technique, can be an effective treatment of gluteus medius tears at a minimum follow-up of 2 years. Longer term follow-up studies are necessary to determine whether these therapeutic and functional gains are maintained.
臀中肌撕裂在中老年女性中可高达 25%，在中年男性中可达 10%，但常被误诊。关节镜下修复臀中肌撕裂的疗效鲜有报道。
报告关节镜下修复部分和全层臀中肌撕裂的早期结果。
病例系列；证据水平，4 级。
作者之一于 2009 年 4 月至 2010 年 1 月期间前瞻性收集所有接受关节镜下臀中肌修复的患者数据。该研究的纳入标准为接受高级别、部分或全层撕裂修复的患者。只有经关节镜证实存在臀中肌撕裂的患者才接受手术治疗。对于关节侧撕裂，采用经肌腱修复技术，而对于全层撕裂，则直接将肌腱固定到骨上。
共 15 例患者符合纳入标准。该队列包括 14 名女性和 1 名男性，平均年龄为 58 岁（范围，4474 岁）。关节镜下发现 6 例为部分层撕裂。9 例为全层或近全层撕裂，均完成修复。所有患者的平均随访时间为术后 27.9 个月（范围，2437 个月）。15 例患者中有 14 例在所有 4 项用于评估结果的髋关节特定评分中均显示术后改善，所有评分的平均改善均超过 30 分。15 例患者中有 14 例报告对手术结果的满意度为良好至优秀（10 分制评分为 7~10 分）。
本研究表明，关节镜下手术修复，无论是经肌腱还是全层技术，在至少 2 年的随访中，都可以成为治疗臀中肌撕裂的有效方法。需要进行更长时间的随访研究，以确定这些治疗和功能的改善是否得以维持。
