BACKGROUND Gluteal tendons tears are increasingly being recognised as a cause of recalcitrant trochanteric pain, but there is a paucity of robust studies analysing the type of tears, results and predictors of outcome. METHODS Patients with gluteal tendon tears resistant to conservative treatment who underwent isolated open repair (IR) or total hip arthroplasty and concomitant repair (THA+repair) with a minimum 1-year follow-up were retrospectively assessed separately. Type of tear, surgical approach, and fixation methods were registered. Complications and postoperative outcomes were analysed: visual analogue scale (VAS) of pain, VAS satisfaction, and activity level. Univariate regressions and multivariable models were developed. RESULTS 90 cases were included: 62 cases underwent IR and 28 cases THA+repair, with an average follow-up of 3.9 years and 2.6 years, respectively. 13 complications were found (n = 5 IR, n = 8 THA+repair), including 9 re-operations (n = 4 IR, n = 5 THA+repair). Mean VAS pain score was 3.02 (SD 2.74) for the IR and 2.32 (SD 2.43) for THA+repair group. Mean VAS satisfaction was 7.09 (SD 3.07) and 7.68 (SD 2.71) for the IR and THA+repair group, respectively. In the IR group 61.4% returned to all pre-injury activities, whereas in the THA+repair group 79% did. Full-thickness tears had higher VAS pain scores (p = 0.0175), and there was trend (p > 0.05) towards higher complications, re-tears and lower VAS satisfaction in this type of tears in both groups. No statistically significant differences were found in outcomes when comparing THA+repair through direct anterior (DAA) with lateral approach (LA). CONCLUSIONS Isolated gluteal tendon repair or THA+repairs seem to be safe procedures with high levels of satisfaction at short- to mid-term follow-up. The presence of a full-thickness tear is a predictor of inferior outcomes.

中文翻译：

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前侧入路开放式修复髋关节外展肌腱的效果分析。

背景技术 臀肌肌腱撕裂越来越多地被认为是顽固性转子疼痛的原因，但缺乏分析撕裂类型、结果和结果预测因素的可靠研究。方法 对保守治疗耐药的臀肌肌腱撕裂患者进行单独的开放式修复（IR）或全髋关节置换术和伴随修复（THA+修复）并至少随访 1 年的患者进行单独回顾性评估。记录撕裂类型、手术入路和固定方法。分析并发症和术后结果：疼痛视觉模拟量表（VAS）、VAS 满意度和活动水平。开发了单变量回归和多变量模型。结果 纳入90例患者，其中62例行IR，28例行THA+修复术，平均随访时间分别为3.9年和2.6年。发现 13 例并发症（n = 5 例 IR，n = 8 例 THA+修复），其中 9 例再次手术（n = 4 例 IR，n = 5 例 THA+修复）。IR 组的平均 VAS 疼痛评分为 3.02 (SD 2.74)，THA+修复组的平均 VAS 疼痛评分为 2.32 (SD 2.43)。IR 组和 THA+修复组的平均 VAS 满意度分别为 7.09 (SD 3.07) 和 7.68 (SD 2.71)。在 IR 组中，61.4% 的人恢复了所有受伤前的活动，而在 THA+修复组中，79% 的人恢复了。两组中全层撕裂的 VAS 疼痛评分较高 (p = 0.0175)，并且存在并发症、再撕裂较高和 VAS 满意度较低的趋势 (p > 0.05)。比较直接前路 (DAA) 与外侧入路 (LA) 的 THA+ 修复术时，结果没有发现统计学上的显着差异。结论 孤立性臀肌肌腱修复术或 THA+ 修复术似乎是安全的手术，在中短期随访中满意度很高。全层撕裂的存在是不良结果的预测因素。