Short- to mid-term outcomes of gluteus maximus transfer for irreparable gluteus medius tears

Abstract

Background:

In cases of large, irreparable gluteus medius (GM) tears, gluteus maximus tendon transfer has emerged as a viable treatment option. The purpose of this study is to evaluate the short- to mid-term outcomes of gluteus maximus transfer as a treatment for irreparable GM tears in the native hip.

Methods:

Data was reviewed for all patients with native hips who underwent gluteus maximus transfer between 2011 and 2021. Patient were eligible for inclusion in the study if they presented with a full thickness irreparable GM tear treated with a gluteus maximus transfer and had completed preoperative and minimum 2-year postoperative questionnaires; or had a documented endpoint (revision surgery) within the study's timeframe. The minimal clinically important difference (MCID) for the mentioned PROs was calculated and included in the analysis.

Results:

A total of 15 native hips were included in the study, with all having a minimum 2-year follow-up and 8 reaching a minimum 5-year follow-up. The study group was predominantly female (93.3%), with a mean age of 66.7 ± 3.1 years, 3 (20%) patients underwent the gluteus maximus transfer as a primary surgery while 12 (80%) underwent a revision surgery from a prior failed GM repair. Significant improvements were observed across all evaluated patient reported outcome measures with high patient satisfaction. Additionally, only 3 patients (20%) showed a residual Trendelenburg gait, with 80% of patients regaining a normal gait. These improvements were sustained from the 2-year to the 5-year timepoint. A high percentage of patients reached the calculated MCID.

Conclusions:

Gluteus maximus transfer remains a salvage procedure for irreparable GM tears. This procedure demonstrated favourable short- to mid-term outcomes, high patient satisfaction rates, high rate of restoration of normal gait, and a substantial percentage of patients achieving clinically meaningful improvements in functional scores.

Keywords

Abductor mechanism gluteus maximus transfer gluteus medius hip preservation native hip

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