Surgical Technique: Using an Acellular Dermal Allograft and Bioresorbable Wick Scaffold During Endoscopic Gluteus Medius and Minimus Repair

Abstract

Lateral hip pain, also known as greater trochanteric pain syndrome, encompasses a spectrum of pathology, including trochanteric bursitis, gluteus medius and minimus tears, and iliotibial band pathology. Patients with greater trochanteric pain syndrome can have tearing of the hip abductors, leading to refractory pain that may necessitate surgical repair. Compared to an open approach, endoscopic gluteus tendon repair is becoming more popular and has been shown to decrease morbidity. Similar to rotator cuff repairs, hip abductor repairs are subject to failure secondary to many factors. These include poor biology, tear size, tissue quality, and deficiency of tendon-to-bone healing. Previous work included the use of acellular dermal allograft to augment at-risk gluteus medius and minimus repairs and improve repair strength. The following technique utilizes a rotium bioresorbable wick scaffold at the bone-tendon interface in addition to an acellular dermal allograft covering the repair in a “biological sandwich” to further augment repair. This technique focuses on the addition of rotium augment implementation and fixation in a safe and reproducible manner.