Ramsay Générale de Santé, Hôpital privé Jean Mermoz, Centre Orthopédique Santy, FIFA Medical Centre of Excellence, Lyon, France.
Ramsay Générale de Santé, Hôpital privé Jean Mermoz, Centre Orthopédique Santy, FIFA Medical Centre of Excellence, Lyon, France.
Arthroscopy. 2021 Aug;37(8):2465-2472. doi: 10.1016/j.arthro.2021.02.020. Epub 2021 Feb 23.
The purpose of this study was to evaluate and compare the functional outcomes after endoscopic repair of partial or full-thickness gluteus medius tears at a minimum 2 years' follow-up.
Patients with isolated tears of the gluteus medius tendon repaired endoscopically between 2012 and 2017 were evaluated at a minimum 2 years of follow-up. Patients with large, retracted and/or irreducible tears, advanced atrophy, or fatty degeneration or with concomitant other hip pathology were excluded. Functional outcomes were assessed using the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), and visual analog scale (VAS) for pain preoperatively and at the last follow-up RESULTS: Forty-six patients, 3 men and 43 women with a mean (SD) age of 63 (9; range, 43-82) years, were included. Thirty-three patients (72%) had partial-thickness tears and 13 (28%) had full-thickness tears. Pain was reduced significantly from a median of 8 (IQR: 6-8) at the preoperative visit to a median of 2 (IQR: 15) at the most recent follow-up (P < .0001). The mHHS and NAHS improved significantly from a median of 44 (IQR: 35-52) to 80 (IQR: 64-87) (P < .0001) and 52 (IQR: 43-56) to 75 (IQR: 66-94) (P < .0001), respectively. These improvements were clinically relevant and surpass the reported minimal clinically important difference. Patients with partial tears had significant functional gains in the mHHS in comparison with patients with full-thickness tears (P = .02). No other statistically significant difference between groups of tear grade was observed.
Endoscopic repair of gluteus medius tendon tears yields excellent functional outcomes at a minimum follow-up of 2 years. A lower functional improvement for full-thickness tears was observed; this difference was statistically significant for 1 of the 2 scores evaluated.
Level III, retrospective comparative cohort.
本研究旨在评估和比较在至少 2 年的随访后，内镜修复部分或全层臀中肌撕裂的功能结果。
在 2012 年至 2017 年间，对接受内镜修复的孤立性臀中肌腱撕裂患者进行了评估，随访时间至少为 2 年。排除有大、回缩和/或不可复位的撕裂、严重萎缩或脂肪变性、或伴有其他髋关节病变的患者。术前和末次随访时，采用改良 Harris 髋关节评分（mHHS）、非关节炎髋关节评分（NAHS）和疼痛视觉模拟评分（VAS）评估功能结果。
共纳入 46 名患者，3 名男性，43 名女性，平均（标准差）年龄为 63（9）岁（范围，43-82 岁）。33 名患者（72%）为部分厚度撕裂，13 名患者（28%）为全层撕裂。疼痛从术前的中位数 8（IQR：6-8）显著降低至末次随访时的中位数 2（IQR：15）（P<0.0001）。mHHS 和 NAHS 分别从中位数 44（IQR：35-52）显著改善至 80（IQR：64-87）（P<0.0001）和 52（IQR：43-56）至 75（IQR：66-94）（P<0.0001），这些改善具有临床意义，超过了报告的最小临床重要差异。与全层撕裂患者相比，部分撕裂患者的 mHHS 功能显著改善（P=0.02）。在撕裂分级组之间没有观察到其他有统计学意义的差异。
在至少 2 年的随访中，内镜修复臀中肌肌腱撕裂可获得优异的功能结果。全层撕裂的功能改善较低，在评估的 2 个评分中的 1 个评分中，这种差异具有统计学意义。
III 级，回顾性比较队列。
