The Regional Microvascular Density of the Gluteus Medius Tendon Determined by Immunohistochemistry with CD31 Staining: A Cadaveric Study

Abstract

There are no studies to date about the vascularisation into the gluteus medius tendon. The purpose of this study was to define the microvessel density of the gluteus medius in 3 zones through a special staining with CD31 and to identify regional differences in microvascular density that may have implications for the healing. We obtained 12 complete gluteus medius tendons from cadavers who had been an average age of 30.3 years old (range 18 to 55). All the donors were males with no known history of hip abnormalities.Following a rigorous protocol, each gluteus medius tendon was divided in 3 portions. Each gluteus medius tendon was divided in 3 portions (I: musculotendinous, II: Tendon, III: Tendon-Bone junction). There were regional differences between all anatomic zones in both the transverse section (p<0.001) and the longitudinal section (p = 0.007). Furthermore, a significant difference was found between zones II and I (mean difference -23.45 IC95% -38.77 to -8.13, p<0.001) and between zones II and III (mean difference -26.08 IC95% -41.39 to -10.76, p<0.001) in transverse section. In longitudinal sections, this difference was found as well between zones II and I (mean difference -29.48 IC95% -51.54 to -7.43, p = 0.01), but not between zones II and III (mean difference -10.87 IC95% -32.93 to 11.18, p = 0.67). The microvessel density was significantly lower in the length of the tendon (central portion) compared to the other 2 regions.