Table 1.
Contemporary systematic reviews regarding surgical management of gluteal tendon tears
| Author | Variable of interest | Number of studies (Number of hips) |
Mean follow-up (mo) | Approach | Postoperative patient-reported outcomes | Retears (n, %) | Conclusions |
|---|---|---|---|---|---|---|---|
| Parker et al. (2020) | IT band sparing versus splitting techniques |
8 (174) Spare: 2 (141) Split: 3 (33) Both: 3 |
Spare: 29.72 ± 5.08 months Split: 28.33 ± 4.88 p = .16 |
Endoscopic |
VAS* Spare: 2.09 ± 0.28 Split: 2.97 ± 0.37 p < 0.01 mHHS* Spare: 81.49 ± 4.75 Split: 80.87 ± 2.94 p = 0.25 |
Spare: 4.75% Split: 3.67%* p = 0.04 |
Patients in ITB-sparing approach were significantly younger and more female. There is a lack of high-quality literature regarding ITB approach. |
| Longstaffe et al. (2021) | Endoscopic versus open gluteal repair techniques | 22 (611) | 27.3 | Open and endoscopic |
mHHS Open: 88 Endoscopic: 78.8 Gait deviation: 54% preoperative of which 70% resolved after repair |
Open: 4.1% Endoscopic: 3.4% |
77.9% of tears were partial thickness while 22.1% were full thickness. 53.3% were isolated involvement of the gluteus medius and 46.0% involved both medius and minimus. Both endoscopic and open approaches to gluteal tendon repair demonstrate improvement in patient-reported outcomes with low retear rate. |
| Ebert et al. (2022) | Post operative rehabilitation protocols | 17 (856) | N/A | Open and endoscopic | N/A | N/A |
Variation in postoperative rehabilitation protocols including weight-bearing restrictions, range of motion, and resistance exercises are reported. An evidence-based seven phase rehabilitation protocol is described. |
| Looney et al. (2022) | Fatty infiltration (FI) on repair outcomes | 4 (206) | 31.7-55.2 | Open and endoscopic |
mHHS*: High-grade FI showed less improvement than low or no FI p = .002 VAS score: No difference by FI p > .05 |
3.8% |
High-grade FI results in less improvement in mHHS though no difference in VAS scores after gluteal tendon repair. There was no difference between open and endoscopic repairs in FI-adjusted improvement, though open repair resulted in greater pain relief at each FI level. |
| Yee et al. (2023) | Intraoperative findings during endoscopic treatment of GTPS | 16 (743) | 5-109 | Endoscopic |
VAS: 10/12 studies report decrease mHHS: 11/13 report improvement NAHS: 8/9 report improvement 94% gluteal tendon tears (72% partial thickness, 20% full thickness) 4 studies reported findings of hip arthroscopy: 85% labral tears, 25% chondral lesions |
2–16% | Patients undergoing endoscopy for GTPS most commonly have partial thickness gluteus medius tendon tears. When concomitant hip arthroscopy is performed, labral tears and chondral lesions are often identified intraoperatively. |
| Song et al. (2023) | Outcomes after gluteus maximus transfer | 10 (125) | 40 | Open and endoscopic |
VAS: 3.1 ± 1.5 mHHS: 77.3 ± 18.5 Gait deviation: 85% preoperative of which 66% resolved after repair |
2.4% | Gluteus maximus transfer for irreparable gluteal tendon tears improves patient-reported outcomes with low retear rates. However, persistent Trendelenburg gait is noted in 33% of patients postoperatively. |
| Akhtar et al. (2024) | Outcomes after endoscopic tendon repair | 13 (272) | 16.4–46.7 | Endoscopic |
Trendelenburg gait persisted 0–13.6% MCID achievement in 50–93.3% PASS achievement in 40.7–75.0% |
0–33.3% | Endoscopic repairs have good-excellent patient-reported outcomes and low retear rates, though rates of MCID and PASS achievement are more variable. |