Abstract
Abductor lesions are increasingly recognized as a source of recalcitrant laterally based hip pain and dysfunction. There is a growing body of evidence that many of these may be amenable to endoscopic repair. To report the demographic data and outcomes of endoscopic hip abductor repair. Twelve patients underwent endoscopic abductor repair with 2-year follow-up. These patients were prospectively assessed with modified Harris hip and iHOT scores. The indications for surgery were clinical and MRI findings of symptomatic abductor tears that had failed conservative treatment. All patients underwent concomitant or prior arthroscopy of the joint. Repair was performed with suture anchors using an iliotibial band-sparing endoscopic technique; followed by a 4-month structured rehabilitation protocol. Follow-up was obtained on all patients at 24 months. The average age was 56 years (range 39–77 years). These were all females. All demonstrated improved modified Harris hip scores, averaging 43 points (preop 42; postop 85). Eleven of 12 (92%) demonstrated improved iHOT scores, averaging 52 points (preop 21; postop 73). Ten patients had accompanying intra-articular pathology including 10 labral tears, 7 chondral lesions, 6 synovitis and 1 pincer impingement. There were no complications, and none underwent further surgery. Abductor tears of the hip can be clinically relevant and respond well to endoscopic repair. This tends to be a disorder of older females who present with severe disability, reflected by low preoperative modified Harris hip scores, and demonstrate significant, although incomplete, improvement.
Highlights
Recalcitrant lateral-sided hip pain was attributed to chronic trochanteric bursitis [1]
Twelve patients underwent endoscopic abductor repair with 2-year follow-up. These patients were prospectively assessed with modified Harris hip and iHOT scores
Historically, recalcitrant lateral-sided hip pain was attributed to chronic trochanteric bursitis [1]
Summary
Recalcitrant lateral-sided hip pain was attributed to chronic trochanteric bursitis [1]. Abductor tendinopathy has been recognized as a more common source of lateral hip pain that fails to respond to conservative treatment [2]. Abductor lesions are a common cause of greater trochanteric pain syndrome, imaging evidence of abductor pathology may be an incidental normal consequence of the aging process identified by MRI [4]. The history and physical examination are essential to establishing the clinical relevance of abductor damage. Ultrasoundguided injections of the abductors may have therapeutic value and are especially helpful in establishing that the tendon damage is the principal pain generator [5, 6]
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