Five-Year Outcomes of Endoscopic Gluteus Medius Repair Show Sustained Functional Improvement and High Clinically Relevant Threshold Achievement
Author(s):Quesada-Jimenez R, Strok MJ, Schab AR, Kahana-Rojkind AH, Domb BG.
DOI Link: 10.1002/arj.70002
Background
Endoscopic gluteus medius (GM) repair has become an established treatment for abductor tendon pathology, though data on midterm durability and clinically meaningful outcomes remain limited.
Methods
A retrospective review of prospectively collected data was performed on patients undergoing isolated endoscopic GM repair with minimum 5-year follow-up. Patient-reported outcomes (mHHS, NAHS, iHOT-12, VAS, satisfaction) were assessed. MCID achievement was calculated using a distribution-based method. Outcomes at 2 and 5 years were compared to evaluate durability. Complications and secondary surgeries were recorded.
Key Findings
Significant improvements were observed across all PROs at ≥5 years (P < .01).
High rates of MCID achievement were reported: mHHS (82.4%), NAHS (82.4%), iHOT-12 (80.0%).
Functional improvements were sustained from 2 to 5 years, with continued improvement in mHHS at 5 years.
High patient satisfaction was reported.
Revision-free survival was 88.5%, with 11.5% undergoing secondary surgery.
All revision cases involved high-grade partial or full-thickness tears and occurred in female patients.
Conclusion
Endoscopic GM repair provides durable, clinically meaningful improvements at midterm follow-up, with high rates of threshold achievement and sustained functional gains over time.
What Does This Mean for Providers?
Endoscopic GM repair is a reliable option for treating abductor tendon pathology, demonstrating durable outcomes through 5 years. Patients with high-grade or full-thickness tears—particularly females—may carry a higher risk for revision and should be counseled accordingly. These findings support the procedure’s long-term efficacy while highlighting the importance of tear severity in prognostication and surgical planning.