Results of Endoscopic Labral Repair With Concomitant Gluteus Medius and/or Minimus Repair Compared With Outcomes of Labral Repair Alone: A Matched Comparative Cohort Analysis at Minimum 2-Year Follow-up

Abstract

Background: There is a paucity of information available to clinicians on outcomes of patients undergoing endoscopic surgery for labral repairs and femoroacetabular impingement syndrome with simultaneous repair of the gluteus medius and/or minimus muscles. Purpose: To determine whether patients with labral tears and concomitant gluteal pathology who undergo simultaneous endoscopic labral and gluteus medius and/or minimus repair experience similar outcomes to patients with isolated labral tears who undergo endoscopic labral repair alone. Study Design: Cohort study; Level of evidence, 3. Methods: A matched retrospective comparative cohort study was performed. Patients who underwent gluteus medius and/or minimus repair with concomitant labral repair between January 2012 and November 2019 were identified. These patients were matched in a 1:3 ratio by sex, age, and body mass index (BMI) to patients who underwent labral repair alone. Preoperative radiographs were assessed. Patient-reported outcomes (PROs) were assessed preoperatively and 2 years postoperatively. PRO measures included the Hip Outcome Score Activities of Daily Living and Sports subscales, modified Harris Hip Score, 12-Item International Hip Outcome Tool, and visual analog scales for pain and satisfaction. Published labral repair minimal clinically important difference (MCID) and Patient Acceptable Symptom State (PASS) thresholds were utilized for these measures. Results: A total of 31 patients who underwent gluteus medius and/or minimus repair with concomitant labral repair (27 female, 4 male; age, 50.8 ± 7.3 years; BMI, 27.9 ± 5.2) were matched with 93 patients who underwent labral repair alone (81 female, 12 male; age, 50.9 ± 8.1 years; BMI, 28.5 ± 6.2). There were no significant differences in sex ( P > .99), age ( P = .869), or BMI ( P = .592); preoperative radiographic measurements; or preoperative or 2-year postoperative PRO scores ( P≥ .081). Changes between preoperative and 2-year postoperative PRO scores were significantly different for both groups for all PROs assessed ( P < .001 for all). There were no significant differences in MCID or PASS achievement rates ( P≥ .123), with low PASS achievement rates of 40% to 60% found in both groups. Conclusion: Patients who were treated with endoscopic gluteus medius and/or minimus repair with concomitant labral repair demonstrated comparable outcomes with those who were treated with endoscopic labral repair alone.