Quinn Matthew, Albright Alex, Kent Victoria, Morrissey Patrick, Katz Luca, Kutschke Michael, Lemme Nicholas, Tabaddor Ramin R
Department of Orthopaedic Surgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, U.S.A.
The Warren Alpert Medical School of Brown University, Providence, Rhode Island, U.S.A.
Arthrosc Sports Med Rehabil. 2024 Jul 9;6(5):100972. doi: 10.1016/j.asmr.2024.100972. eCollection 2024 Oct.
To evaluate the efficacy of the senior author's hybrid "mini-open" technique for abductor tendon repair at 2-year follow-up.
After institutional review board approval, we performed a retrospective review of prospectively collected data for all patients undergoing isolated mini-open gluteus medius tendon repairs from January 2018 to January 2022. Inclusion criteria included ongoing abductor pain refractory to nonoperative management, magnetic resonance imaging demonstrating gluteus medius/minimus tear, completion of preoperative patient-reported outcome measures (PROMs) including Modified Harris Hip Score (mHHS), Hip Outcome Score for Activities of Daily Living (HOS-ADL), Hip Outcome Score for Sports-Related Activities (HOS-SS), and visual analog scale (VAS) for pain and minimum 2-year follow-up. PROMs were assessed at preoperative, 6-month, 1-year, and 2-year postoperative intervals. Paired-sample tests were used to compare the change in each outcome measure. The minimal clinically important difference (MCID) was calculated, and complications were recorded.
Sixty-one patients (59 female, 96.7%) with an average age of 61.4 ± 1.3 years were included. The mean follow-up was 25.9 ± 1.13 months. mHHS improved from a mean of 47.2 preoperatively to 68.9 at 2 years ( < 0.001), HOS-ADL from 54 to 78.9 ( < 0.001), HOS-SS from 37 to 66.5 ( = 0.015), and VAS from 13.3 to 7.4 ( = 0.001). The MCIDs for mHHS, HOS-ADL, HOS-SS, and VAS were 11.1 (60% achievement), 6.1 (78.6% achievement), 9.7 (80.3% achievement), and 14.5 (75.4% achievement), respectively. Two patients experienced retears (3.2%), with no other complications reported.
The mini-open technique for abductor tendon repair provides sustained improvement in both pain and function-related PROMs at 2-year follow-up with comparable complication rates to endoscopic and open techniques in 1 surgeon's practice.
Level IV, therapeutic retrospective case series.
在2年随访期评估资深作者的混合“迷你开放”技术用于外展肌腱修复的疗效。
经机构审查委员会批准后，我们对2018年1月至2022年1月期间所有接受单纯迷你开放臀中肌腱修复的患者的前瞻性收集数据进行了回顾性分析。纳入标准包括非手术治疗无效的持续性外展疼痛、磁共振成像显示臀中肌/臀小肌撕裂、完成术前患者报告结局测量（PROMs），包括改良Harris髋关节评分（mHHS）、日常生活髋关节结局评分（HOS-ADL）、与运动相关活动的髋关节结局评分（HOS-SS）以及疼痛视觉模拟量表（VAS），且随访至少2年。在术前、术后6个月、1年和2年时评估PROMs。采用配对样本检验比较各结局测量指标的变化。计算最小临床重要差异（MCID），并记录并发症情况。
纳入61例患者（59例女性，96.7%），平均年龄61.4±1.3岁。平均随访时间为25.9±1.13个月。mHHS从术前平均47.2分提高到2年时的68.9分（P<0.001），HOS-ADL从54分提高到78.9分（P<0.001），HOS-SS从37分提高到66.5分（P=0.015），VAS从13.3分降低到7.4分（P=0.001）。mHHS、HOS-ADL、HOS-SS和VAS的MCID分别为11.1（达成率60%）、6.1（达成率78.6%）、9.7（达成率80.3%）和14.5（达成率75.4%）。2例患者出现再次撕裂（3.2%），未报告其他并发症。
在1名外科医生的实践中，外展肌腱修复的迷你开放技术在2年随访期能使疼痛和功能相关的PROMs持续改善，并发症发生率与内镜和开放技术相当。
IV级，治疗性回顾性病例系列。
