Dermal Allograft Augmentation for Open Gluteus Medius Repair: A Case Series at 2-Year Follow-up
Author(s):Quesada-Jimenez R, O'Brien EJ, Walsh EG, Kahana-Rojkind AH, Kuhns BD, Domb BG.
DOI Link: 10.1177/03635465251399214
Background
Gluteus medius (GM) tears are a recognized source of peritrochanteric pain and dysfunction. In cases of poor tendon quality or failed prior repair, dermal allograft augmentation may enhance the mechanical strength and biologic environment of repair constructs.
Methods
This Level 4 case series retrospectively analyzed prospectively collected data on patients undergoing open GM repair with dermal allograft augmentation between 2016 and 2022. Inclusion required preoperative and minimum 2-year follow-up data or a defined clinical endpoint. Outcomes included patient-reported outcome measures (mHHS, NAHS, iHOT-12, VAS pain), satisfaction, MCID achievement, complication rates, and secondary surgery. A sex-based subgroup analysis was performed.
Key Findings
A total of 23 hips (18 female, 5 male) were included; 73.9% were primary augmentations and 26.1% were revision cases.
Significant improvement was observed across all PROMs at 2-year follow-up.
Low reoperation rate was observed (4.4%; 1/23 hips for recurrent tear).
Clinically meaningful outcomes were achieved at high rates:
- MCID: mHHS 86.4%, NAHS 81.8%, iHOT-12 72.7%
- PASS: 72.7% of patients
Female patients demonstrated greater postoperative improvement and higher rates of achieving clinically meaningful thresholds compared with male patients.
Conclusion
Open gluteus medius repair with dermal allograft augmentation yields significant short-term improvements in pain and function with low reoperation rates, including in revision settings.
What Does This Mean for Providers?
Dermal allograft augmentation is a viable adjunct in the management of complex or degenerative gluteus medius tears, particularly in cases of poor tissue quality or revision repair. Early results demonstrate high rates of clinically meaningful improvement and low failure rates, with potential sex-based differences in outcome response that may warrant further study.