Humanitas Research Hospital-IRCCS, Via Alessandro Manzoni 36, Rozzano, MI, Italy.
IRCCS Istituto Ortopedico Galeazzi, Via Galeazzi 4, 20161, Milan, Italy.
Knee Surg Sports Traumatol Arthrosc. 2023 May;31(5):2038-2045. doi: 10.1007/s00167-022-07140-x. Epub 2022 Sep 6.
The current study aimed to report the mid-term follow-up results of endoscopic gluteus medius repair combined with a systematic release of the gluteus maximus reflected tendon.
Twenty-two patients with a symptomatic full-thickness tear of the gluteus medius tendon, as diagnosed by clinical examination and imaging (MRI), and who had a failure of conservative treatment for at least 6 months, were retrospectively enrolled for this study. An endoscopic repair of gluteus medius was performed for all patients in combination with gluteus maximus reflected tendon release according to the Polesello technique. The Visual Analogue Scale (VAS) for pain, Modified Harris Hip Score (mHHS), Lower Extremity Functional Scale (LEFS), Hip Outcome Score-Activity Daily Life (HOS-ADL), and Hip Outcome Score-Sport Specific Subscale (HOS-SSS) were administered to each patient before surgery for 6 months, 1 year, and every following year after surgery.
All analysed hip scores (mHHS, LEFS, HOS-ADL, and HOS-SSS) showed statistically significant improvements between the pre-operative and post-operative values at 6 months, 1 year, and the latest follow-up appointments after surgery (p < 0.001). The mean pre-operative pain was 8.6 ± 1.0 on the VAS. After surgical treatment, the pain was significantly reduced (p < 0.001) on the VAS at 6 months (5.4 ± 1.5), 1 year (4.4 ± 1.8) and the latest follow-up control visit (3.6 ± 2.2). No patient-reported major complications (re-rupture, deep infection or neurovascular injury). Eleven (50%) patients indicated the results as excellent, 7 (32%) as good, 2 (9%) as fair, and 2 (9%) as poor.
The use of abductor tendon repair in combination with a systematic release of the reflected tendon of the gluteus maximus according to the Polesello technique seems to be a safe and effective endoscopic way of treating a full-thickness tear of the gluteus medius.
Level IV.
本研究旨在报告经内镜修复臀中肌结合系统释放臀大肌反射肌腱的中期随访结果。
回顾性纳入 22 例经临床检查和影像学（MRI）诊断为臀中肌肌腱全层撕裂且保守治疗至少 6 个月失败的患者。所有患者均行内镜下臀中肌修复术，并根据 Polesello 技术行臀大肌反射肌腱松解术。术前、术后 6 个月、1 年及之后每年，对每位患者进行视觉模拟评分（VAS）疼痛评分、改良 Harris 髋关节评分（mHHS）、下肢功能评分（LEFS）、髋关节结局评分-日常生活活动（HOS-ADL）和髋关节结局评分-运动专项量表（HOS-SSS）。
mHHS、LEFS、HOS-ADL 和 HOS-SSS 所有分析髋关节评分在术后 6 个月、1 年和末次随访时与术前相比均有统计学显著改善（p < 0.001）。术前 VAS 平均疼痛评分为 8.6 ± 1.0。经手术治疗后，6 个月时疼痛明显减轻（p < 0.001）（5.4 ± 1.5），1 年时（4.4 ± 1.8）和末次随访时（3.6 ± 2.2）。无患者报告重大并发症（再撕裂、深部感染或神经血管损伤）。11 例（50%）患者认为结果为优，7 例（32%）为良，2 例（9%）为可，2 例（9%）为差。
根据 Polesello 技术，使用外展肌腱修复结合系统释放臀大肌反射肌腱似乎是治疗臀中肌全层撕裂的一种安全有效的内镜方法。
IV 级。
