Gluteus Medius Partial Tear Repair with Collagen Patch Augmentation. Endoscopic Surgical Technique

Dante Parodi^1,2, José Tomás Bravo³*, Israel González⁴, Diego Villegas¹ and Carlos Tobar⁵

¹Department of Orthopedic Surgery, Clínica Las Condes, Santiago, Chile
²Facultad de Medicina, Universidad Finis Terrae, Santiago, Chile
³Department of Orthopedic Surgery, Hospital Juán Noé Crevani, Arica, Chile
⁴Department of Orthopedic Surgery, Hospital Ángeles, Santiago de Querétaro, México
⁵Department of Orthopedic Surgery, Clínica RedSalud Providencia, Santiago, Chile

*Corresponding Author: José Tomás Bravo, Department of Orthopedic Surgery, Hospital Juán Noé Crevani, Arica, Chile.

Received: November 20, 2023; Published: December 13, 2023

Abstract

Introduction: Gluteus medius (GM) partial and total tears frequently cause lateral hip pain and can be highly disabling. These injuries are challenging to treat conservatively. Partial tears occur more often than total tears. If conservative management fails, open and endoscopic repair techniques can be used as treatment options. The use of collagen patches has been proposed as an augmentation for decreasing non-healing rates.

The purpose of this study is to describe our endoscopic technique for repairing partial tears of the GM tendon using a bioinductive collagen patch.

Surgical Technique: With the patient in the supine position on a table without traction, the proximal posterolateral accessory and distal posterolateral accessory portals previously described for deep gluteal pain syndrome are performed.

A wide bursectomy and a partial tenotomy of the distal insertion of the gluteus maximus are performed. The tendinopathic appearance of the GM tendon is identified on the lateral surface, evidencing the partial tear when palpating the tendon on its medial side.

The medium posterolateral accessory portal is made to perform 9 perforations on the greater trochanter at the level of the gluteus medius tendon. The collagen patch is placed over the perforations, placing the anchors to fix the patch. Finally, the stability of the patch is checked with hip movements.

Conclusion: Our endoscopic technique for the repair of the GM tendon, performing multiple perforations to the greater trochanter, and using a bioinductive collagen patch augmentation, is reproducible and safe. The partial tenotomy of the distal insertion of the gluteus maximus may decompress the iliotibial band over the repaired GM tendon. These endoscopic portals allow access to the entire lateral peritrochanteric space, in addition to allowing management of the deep gluteal space if necessary.

Keywords: Gluteus Medius; Partial Tear; Collagen Patch; Augmentation; Endoscopic Surgical

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Citation

Citation: José Tomás Bravo., et al. “Gluteus Medius Partial Tear Repair with Collagen Patch Augmentation. Endoscopic Surgical Technique".Acta Scientific Orthopaedics 7.1 (2024): 12-17.

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Copyright: © 2024 José Tomás Bravo., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.