Portela-Parra Eduardo, Sappey-Marinier Elliot, Julian Kaitlyn, Bini Stefano A
Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California, USA.
Orthop J Sports Med. 2025 Jan 1;13(1):23259671241290320. doi: 10.1177/23259671241290320. eCollection 2025 Jan.
Hip abductor tendon tears have been identified as a common cause of greater trochanteric pain syndrome. While abductor tendon tears are often managed surgically, the optimal tendon attachment technique remains controversial.
To compare the outcomes of hip abductor tendon repair between the suture anchor (SA) and transosseous suture (TS) techniques.
Systematic review; Level of evidence, 4.
A literature search was performed in June 2023 in Embase, PubMed, and Web of Science databases. Studies reporting pre- and postoperative clinical outcomes of hip abductor repairs using SA or TS fixation with a minimum follow-up of 12 months were included in our analysis. From 608 studies initially identified, 21 studies (14 SA and 7 TS) with a total of 680 patients met the inclusion criteria. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist guided the reporting and data abstraction, and the quality of the studies was assessed using the methodological index for non-randomized studies checklist. The results were presented as a narrative summary using descriptive statistics such as ranges and agreement statistics.
Significant pre- to postoperative improvement in pain scores and functional outcomes were reported on all included studies. The mean improvement on the Harris Hip Score/modified Harris Hip Score was 32.5 (95% CI, 28.4-36.7) for the SA technique versus 21.9 (95% CI, 6.7-37.0) for the TS technique, while mean improvement in pain according to the visual analog scale was 5.1 ± 2.3 for SA and 4.8 ± 2.2 for TS ( = .9). There was a trend toward statistical significance regarding retear rates, with higher rates for SA (6.7% ± 7.6%) versus TS (1.3% ± 4.7%) ([13.9] = 2.0; = .06).
We observed no significant difference between SA and TS regarding improvements in patient-reported hip outcome and pain scores. However, SA trended toward a higher retear rate. Future research should propose a classification scheme that considers tear size and morphology, the extent of associated muscle degeneration, and the distance of tendon retraction to provide more context for the understanding of expected functional outcomes.
髋外展肌腱撕裂已被确认为大转子疼痛综合征的常见病因。虽然外展肌腱撕裂通常通过手术治疗，但最佳的肌腱附着技术仍存在争议。
比较缝线锚钉（SA）技术和经骨缝合（TS）技术在髋外展肌腱修复中的疗效。
系统评价；证据等级，4级。
于2023年6月在Embase、PubMed和Web of Science数据库中进行文献检索。纳入分析的研究报告了使用SA或TS固定进行髋外展肌修复的术前和术后临床结果，且随访时间至少为12个月。在最初识别的608项研究中，有21项研究（14项SA和7项TS）共680例患者符合纳入标准。PRISMA（系统评价和Meta分析的首选报告项目）清单指导报告和数据提取，并使用非随机研究方法学指标清单评估研究质量。结果采用描述性统计（如范围和一致性统计）进行叙述性总结。
所有纳入研究均报告了术前至术后疼痛评分和功能结果的显著改善。SA技术组Harris髋关节评分/改良Harris髋关节评分的平均改善为32.5（95%CI，28.4 - 36.7），而TS技术组为21.9（95%CI，6.7 - 37.0）；根据视觉模拟量表，SA组疼痛的平均改善为5.1±2.3，TS组为4.8±2.2（P = 0.9）。再撕裂率有统计学意义的趋势，SA组（6.7%±7.6%）高于TS组（1.3%±4.7%）（Z[13.9]=2.0；P = 0.06）。
我们观察到，在患者报告的髋关节结局和疼痛评分改善方面，SA和TS之间无显著差异。然而，SA的再撕裂率有升高趋势。未来的研究应提出一种分类方案，该方案考虑撕裂大小和形态、相关肌肉退变程度以及肌腱回缩距离，以便为理解预期功能结果提供更多背景信息。
