Comparable Pain Levels and Functional Outcomes With and Without the Use of Dermal Allograft Augmentation in Endoscopic Gluteus Medius Repair

Abstract

PurposeTo retrospectively compare the clinical outcomes of patients undergoing endoscopic gluteal tendon repair with and without the use of dermal allograft augmentation. MethodsA retrospective review of prospectively collected data, single-surgeon cohort study was performed on all patients undergoing endoscopic gluteus medius repair (GMR) and gluteus medius repair with augmentation (GMR-A) between April 2017 and April 2022. Dermal allograft augmentation was utilized in cases where intraoperative gluteus tissue quality was poor. An electronic survey of patient-reported outcome measures (PROMs) was completed at a minimum of 1 year postoperatively. PROMs included a Visual Analogue Scale (VAS) for pain; University of California, Los Angeles (UCLA) Activity Scale; modified Harris Hip Score (mHHS); Hip Outcome Score-Sport-Specific Subscale (HOS-SSS); and a Single Assessment Numeric Evaluation (SANE). The proportion of patients achieving the minimal clinically important difference (MCID), patient acceptable symptom state (PASS), and substantial clinical benefit (SCB) for each PROM were compared between groups. ResultsSixty-four patients were reached for follow-up (26 GMR, 38 GMR-A). No differences were found between the groups in terms of demographics. There was a significantly longer time to follow-up in the GMR group (39.4±26.9 vs 24.2±11.7 months, p=0.003). There were no differences between the GMR and GMR-A groups in terms of postoperative PROMs including VAS (3.3±2.6 vs 3.3±2.8, p=0.99), UCLA (5.8±2.1 vs 5.1±2.0, p=0.17), mHHS (70.1±18.1 vs 68.9±17.8, p=0.80), HOS-SSS (67.7±28.9 vs 62.5±30.2, p=0.50), and SANE (71.7±27.9 vs 71.3±22.8, p=0.95). A significantly greater proportion of patients in the GMR group achieved a PASS for UCLA (64% vs. 34%, p=0.02). One patient each in the GMR (3.8%) and GMR-A (2.6%) groups underwent revision gluteus medius repair with dermal allograft augmentation at the final follow-up. ConclusionsOur study demonstrates comparable clinical outcomes with and without the use of dermal allograft augmentation in endoscopic gluteus medius repairs. Level of EvidenceIII, retrospective comparative series