Abstract：
The transtendinous technique has been used to treat partial-thickness gluteus medius tears in the setting of concomitant arthroscopy for labral tears. The tendon compression bridge technique for gluteus medius repair has been developed as an alternative method, providing several advantages; however, comparative studies between the 2 techniques are lacking in the literature.
(1) To evaluate the short-term patient-reported outcomes (PROs) of the tendon compression bridge technique and (2) to compare these findings with short-term PROs of the transtendinous technique.
Cohort study; Level of evidence, 3.
Data were prospectively collected on patients who were followed for a minimum of 2 years after an endoscopic tendon compression bridge procedure for gluteus medius repair in the setting of concomitant hip arthroscopy for labral tears. The following PROs were collected preoperatively and postoperatively: modified Harris Hip Score, Nonarthritic Hip Score, Hip Outcome Score-Sports Specific Subscale, visual analog scale score for pain, and the International Hip Outcome Tool. Clinical outcomes were assessed using the Patient Acceptable Symptom State, minimal clinically important difference, and maximum outcome improvement satisfaction threshold. Patients were propensity matched 1:1 to a cohort that underwent gluteus medius repair using the endoscopic transtendinous technique with concomitant hip arthroscopy.
A total of 48 hips (48 patients) that met inclusion criteria (age, 53.3 ± 9.8 years; 92% female; body mass index, 26.7 ± 4.6), with a mean follow-up of 38.5 ± 15.7 months, were matched to 48 hips (46 patients) that underwent gluteus medius repair using the transtendinous technique. Both groups demonstrated significant improvement from preoperative scores to latest follow-up (P < .05). Mean magnitude of improvement and latest follow-up scores were not significantly different between the tendon compression bridge group and the transtendinous group, and the groups demonstrated similar favorable rates of achieving Minimal Clinically Important Difference (79% vs 79%, respectively), Patient Acceptable Symptom State (73% vs 73%, respectively), and Maximum Outcome Improvement Satisfaction threshold (65% vs 58%, respectively) for modified Harris Hip Score (P > .05). Patient satisfaction between groups was similar (8.1 ± 2.2 vs 7.7 ± 2.7, respectively) (P = .475).
At minimum 2-year follow-up, the endoscopic tendon compression bridge technique for partial-thickness gluteus medius tears, when performed with concomitant hip arthroscopy, was associated with significant improvement in functional outcomes. These postoperative results were comparable with those of a matched cohort that underwent the endoscopic transtendinous technique for partial-thickness gluteus medius tears, suggesting that the tendon compression bridge technique for gluteus medius repair is an effective treatment option for partial-thickness gluteus medius tears.
(1) To evaluate the short-term patient-reported outcomes (PROs) of the tendon compression bridge technique and (2) to compare these findings with short-term PROs of the transtendinous technique.
Cohort study; Level of evidence, 3.
Data were prospectively collected on patients who were followed for a minimum of 2 years after an endoscopic tendon compression bridge procedure for gluteus medius repair in the setting of concomitant hip arthroscopy for labral tears. The following PROs were collected preoperatively and postoperatively: modified Harris Hip Score, Nonarthritic Hip Score, Hip Outcome Score-Sports Specific Subscale, visual analog scale score for pain, and the International Hip Outcome Tool. Clinical outcomes were assessed using the Patient Acceptable Symptom State, minimal clinically important difference, and maximum outcome improvement satisfaction threshold. Patients were propensity matched 1:1 to a cohort that underwent gluteus medius repair using the endoscopic transtendinous technique with concomitant hip arthroscopy.
A total of 48 hips (48 patients) that met inclusion criteria (age, 53.3 ± 9.8 years; 92% female; body mass index, 26.7 ± 4.6), with a mean follow-up of 38.5 ± 15.7 months, were matched to 48 hips (46 patients) that underwent gluteus medius repair using the transtendinous technique. Both groups demonstrated significant improvement from preoperative scores to latest follow-up (P < .05). Mean magnitude of improvement and latest follow-up scores were not significantly different between the tendon compression bridge group and the transtendinous group, and the groups demonstrated similar favorable rates of achieving Minimal Clinically Important Difference (79% vs 79%, respectively), Patient Acceptable Symptom State (73% vs 73%, respectively), and Maximum Outcome Improvement Satisfaction threshold (65% vs 58%, respectively) for modified Harris Hip Score (P > .05). Patient satisfaction between groups was similar (8.1 ± 2.2 vs 7.7 ± 2.7, respectively) (P = .475).
At minimum 2-year follow-up, the endoscopic tendon compression bridge technique for partial-thickness gluteus medius tears, when performed with concomitant hip arthroscopy, was associated with significant improvement in functional outcomes. These postoperative results were comparable with those of a matched cohort that underwent the endoscopic transtendinous technique for partial-thickness gluteus medius tears, suggesting that the tendon compression bridge technique for gluteus medius repair is an effective treatment option for partial-thickness gluteus medius tears.
摘要：
■经突技术已被用于在伴随关节镜检查下治疗唇瓣撕裂的情况下治疗部分厚型臀中肌撕裂。用于臀中肌修复的肌腱压缩桥技术已被开发为替代方法，提供了几个优点；然而，文献中缺乏两种技术之间的比较研究。
■(1)评估肌腱压迫桥技术的短期患者报告结果(PROs)和(2)将这些发现与经肌腱技术的短期PROs进行比较。
■队列研究；证据水平，3.
■前瞻性地收集了患者的数据，这些患者在同时行髋关节镜检查治疗唇二尖瓣撕裂的情况下，在进行了内窥镜下肌腱压缩桥手术治疗臀中肌修复后至少随访了2年。术前和术后收集以下PRO：改良Harris髋关节评分，非关节炎髋关节评分,髋关节结果分数-运动特定分量表，疼痛的视觉模拟量表评分，和国际髋关节结果工具。使用患者可接受的症状状态评估临床结果，最小的临床重要差异，和最大结果改善满意度阈值。患者的倾向与使用内窥镜下经肌腱技术和伴随的髋关节镜检查进行臀中肌修复的队列1：1匹配。
■符合纳入标准（年龄，53.3±9.8岁；92%女性；体重指数，26.7±4.6),平均随访38.5±15.7个月，与使用经突技术进行臀中肌修复的48髋（46例患者）相匹配。两组患者从术前评分到最新随访均有显著改善（P<0.05）。肌腱压迫桥组和跨肌腱组的平均改善程度和最新随访评分无显著差异，两组在实现最小临床重要差异方面表现出相似的良好率(79%vs79%，分别)，患者可接受的症状状态（73%vs73%，分别)，和最大结果改善满意度阈值(65%对58%，分别)用于改良的Harris髋关节评分(P>.05)。两组患者的满意度相似（分别为8.1±2.2和7.7±2.7）（P=.475）。
■在至少2年的随访中，内镜下肌腱压缩桥技术治疗臀中肌部分厚度撕裂，当同时进行髋关节镜检查时，与功能结局的显着改善有关。这些术后结果与接受内镜下经肌腱技术治疗臀中肌部分厚度撕裂的匹配队列的结果相当。提示肌腱压缩桥技术修复臀中肌部分厚型臀中肌撕裂是一种有效的治疗选择。
■(1)评估肌腱压迫桥技术的短期患者报告结果(PROs)和(2)将这些发现与经肌腱技术的短期PROs进行比较。
■队列研究；证据水平，3.
■前瞻性地收集了患者的数据，这些患者在同时行髋关节镜检查治疗唇二尖瓣撕裂的情况下，在进行了内窥镜下肌腱压缩桥手术治疗臀中肌修复后至少随访了2年。术前和术后收集以下PRO：改良Harris髋关节评分，非关节炎髋关节评分,髋关节结果分数-运动特定分量表，疼痛的视觉模拟量表评分，和国际髋关节结果工具。使用患者可接受的症状状态评估临床结果，最小的临床重要差异，和最大结果改善满意度阈值。患者的倾向与使用内窥镜下经肌腱技术和伴随的髋关节镜检查进行臀中肌修复的队列1：1匹配。
■符合纳入标准（年龄，53.3±9.8岁；92%女性；体重指数，26.7±4.6),平均随访38.5±15.7个月，与使用经突技术进行臀中肌修复的48髋（46例患者）相匹配。两组患者从术前评分到最新随访均有显著改善（P<0.05）。肌腱压迫桥组和跨肌腱组的平均改善程度和最新随访评分无显著差异，两组在实现最小临床重要差异方面表现出相似的良好率(79%vs79%，分别)，患者可接受的症状状态（73%vs73%，分别)，和最大结果改善满意度阈值(65%对58%，分别)用于改良的Harris髋关节评分(P>.05)。两组患者的满意度相似（分别为8.1±2.2和7.7±2.7）（P=.475）。
■在至少2年的随访中，内镜下肌腱压缩桥技术治疗臀中肌部分厚度撕裂，当同时进行髋关节镜检查时，与功能结局的显着改善有关。这些术后结果与接受内镜下经肌腱技术治疗臀中肌部分厚度撕裂的匹配队列的结果相当。提示肌腱压缩桥技术修复臀中肌部分厚型臀中肌撕裂是一种有效的治疗选择。
