Dante Parodi^1,2, José Tomás Bravo³*, Daniela Seidel⁴, Diego Villegas¹ and Carlos Tobar¹

¹Department of Orthopedic Surgery, Clínica Las Condes, Santiago, Chile
²Facultad de Medicina, Universidad Finis Terrae, Santiago, Chile
³Facultad de Medicina, Universidad de Tarapacá, Arica, Chile
⁴The American British Cowdray Medical Center, México City, México

*Corresponding Author: José Tomás Bravo, Department of Orthopedic Surgery, Clínica Las Condes, Santiago, Chile.

Received: November 26, 2024; Published: January 24, 2025

Abstract

Introduction: Gluteus medius (GM) partial and complete tears frequently cause lateral hip pain. Conservative treatment of these injuries presents significant challenges. In cases where nonsurgical management proves ineffective, open and endoscopic repair techniques may be employed. Collagen patches have been proposed as augmentation methods to mitigate nonhealing rates. However, no study has directly assessed healing through secondary evaluation. This study presents the first series of cases in which direct healing was observed following repair of the GM tendon with bio-inductive collagen patches.

Methods: This is a prospective, cohort observational study. In all cases, the author (DP) performed endoscopic GM repair using a collagen patch, Regeneten^®, between 2019 and 2024.

Cases in which a second look, open or endoscopic, was performed by any cause were included. The modified Harris Hip Score (mHHS), iHOT-12, and Visual Analog Scale (VAS) scores preoperatively and postoperatively at the first surgery were recorded. The causes of the second look and evaluation of GM healing were assessed in all cases. Complications during the follow-up were recorded.

Results: Thirty consecutive patients underwent surgery for a gluteus medius partial tear with our endoscopic technique. Three cases (10%) required a second look to evaluate GM healing. All cases were women, with an average age of 59 (42-72) years and an average pain of 3.33 (2-5) years.

The preoperative mHHS, iHOT-12, and VAS were 55.33 (34-67), 57 (43-58) and 7 (6-8) respectively. The postoperative mHHS, iHOT-12, and VAS were 82.33 (80-85), 79.66 (77-82), and 1.66 (1-2), respectively at 6-month after the first surgery. Second-look arthroscopy was performed due to intra-articular pain, total hip arthroplasty due to hip osteoarthritis, and late collected hematoma secondary to trauma. The mean time from the first to the second surgery was 2.61 (0.83-4) years.

Direct tendon healing was observed in all cases, with complete dissolution of the collagen patch. The first surgery using a collagen patch did not cause any complications.

Conclusion: All cases evaluated through second-look surgery demonstrated complete healing of the previously repaired GM tear with a collagen patch observed directly. No complications were associated with the initial endoscopic surgery. The present study is the first to report on this matter in hip surgery.

 Keywords: Gluteus Medius; Tendon Healing; Bio-inductive; Collagen; Patches

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Citation

Citation: José Tomás Bravo., et al. “Direct Evaluation of Gluteus Medius Tendon Healing in Patients Previously Operated on with Bio-inductive Collagen Patches".Acta Scientific Orthopaedics 8.2 (2025): 03-08.

Copyright

Copyright: © 2025 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.