Short- to mid-term outcomes of gluteus maximus transfer for irreparable gluteus medius tears
Author(s):Quesada-Jimenez R, Walsh EG, Rana K, Kahana-Rojkind AH, Domb BG.
DOI Link: 10.1177/11207000251371551
Background
Irreparable gluteus medius (GM) tears represent a challenging source of lateral hip pain and abductor dysfunction. Gluteus maximus tendon transfer is a salvage procedure designed to restore abductor function in cases where primary repair is not feasible or has failed.
Methods
This Level 4 retrospective case series evaluated patients with native hips undergoing gluteus maximus transfer for full-thickness irreparable GM tears between 2011 and 2021. Inclusion required minimum 2-year follow-up PROs or documented endpoint (revision surgery), with a subset reaching 5-year follow-up. Outcomes included validated patient-reported outcome measures, MCID achievement rates, gait analysis (Trendelenburg sign), and patient satisfaction.
Key Findings
A total of 15 hips were included; most patients were elderly females, and the majority underwent the procedure as revision surgery following failed prior GM repair.
Key outcomes:
- Significant improvement across all PRO measures
- High patient satisfaction
- MCID achieved in a high proportion of patients
- Trendelenburg gait persisted in 20% of patients, while 80% regained normal gait
- Functional improvements were sustained from 2-year to 5-year follow-up
Conclusion
Gluteus maximus transfer provides meaningful short- to mid-term clinical improvement for irreparable GM tears, with high satisfaction and durable functional gains in most patients, supporting its role as a salvage abductor reconstruction strategy.
What Does This Mean for Providers?
For patients with irreparable or failed gluteus medius repairs, gluteus maximus transfer remains a reliable salvage option. Providers should counsel patients that while most achieve significant functional improvement and gait normalization, a subset may continue to demonstrate residual abductor weakness or Trendelenburg gait. Outcomes appear durable through midterm follow-up.