Editorial Commentary: Long-Term Follow-Up After Endoscopic Gluteal Repair Plus Hip Arthroscopy Shows Durable Results Using Validated Patient-Reported Outcome Scores That Largely Exceed the Minimal Clinically Important Difference and Patient Acceptable Symptom State

Abstract

Gluteus medius and minimus tendon pathology is a common cause of lateral hip pain. In patients who are dissatisfied with their hip condition following nonsurgical treatment, gluteal repair has demonstrated excellent short-, mid-, and, now recently, long-term subjective patient-reported and objective clinician-measured outcomes. In patients with peritrochanteric hip pain, the proportion of their overall hip pain may be influenced by the hip joint due to conditions like femoroacetabular impingement syndrome, acetabular dysplasia, labral tears, and arthritis. Thus, surgical decision-making must include consideration of also addressing the joint at the same time as the gluteal repair. This is sometimes challenging due to the high frequency of observing labral injuries and cam/pincer/dysplasia morphology in patients without symptoms due to the “radiographic abnormalities.” Labral pathology is also more prevalent in older patients, who happen to also be those individuals with symptomatic gluteal tendon pain. Both open and endoscopic approaches to the gluteal tendons have advantages and disadvantages without significant outcomes differences in the short- or mid-term. Long-term clinical follow-up of patients treated with endoscopic gluteal repair with or without concomitant hip arthroscopy should be included in large national and international prospective registries using validated, reliable, and responsive patient-reported outcome scores, with clinical importance assessed using the minimal clinically important difference, patient acceptable symptom state, substantial clinical benefit, and maximal outcome improvement.