A Roadmap to Develop Clinical Guidelines for Open Surgery of Acute and Chronic Tears of Hip Abductor Tendons

Overview

Journal Knee Surg Sports Traumatol Arthrosc

Publisher Wiley

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2020 Oct 20

PMID 33079258

Citations 6

Authors

Eustathios Kenanidis

Bent Lund

Panayiotis Christofilopoulos

Affiliations

Soon will be listed here.

Abstract

Purpose: Abductor tendon tears are increasingly recognised as a common cause of lateral hip pain. Surgical treatment of these tears has been recommended, but the indications and types of open surgery have not been precisely elucidated yet. This manuscript aimed to critically review the literature concerning all open treatment options for this condition while identifying knowledge gaps and introducing a treatment algorithm.

Methods: Literature search was conducted, including PubMed, Cochrane library, ScienceDirect and Ovid MEDLINE from 2000 to May 2020. Inclusion criteria were set as: (i) clinical studies reporting outcomes following open surgical treatment of acute or chronic hip abductor tendon tears, (ii) studies reporting an open direct or augmented suturing or muscle transfer procedure, (iii) acute or chronic tears found in native or prosthetic hips.

Results: A total of 34 studies published between 2004 and 2020 were included. The vast majority of studies were uncontrolled case series of a single treatment method. A total of 970 patients (76% women) with an age range between 48 and 76 years were involved. Women between 60 and 75 years old were most commonly treated. Preoperative evaluation of patients and reporting of open surgical technique and outcomes are inconsistent. All studies reported variable improvement of pain, functional outcomes and gait of patients. Overall, complication rates ranged from 0 to 31.2%.

Conclusion: The current literature on this topic is highly heterogeneous, and the overall level of the available evidence is low. A roadmap to develop practical guidelines for open surgery of acute and chronic tears of abductor tendons is provided. The anatomy and chronicity of the lesion, the extent of fatty infiltration and neurologic integrity of hip abductor muscles may influence both treatment choice and outcome. Further high-quality studies with standardisation of preoperative evaluation of patients and reporting of outcomes will help delineate best treatments.

Level Of Evidence: IV.

Citing Articles

Clinical Outcomes of Hip Abductor Repair Using Transosseous Sutures Versus Suture Anchors: A Systematic Review and Meta-analysis.

Portela-Parra E, Sappey-Marinier E, Julian K, Bini S Orthop J Sports Med. 2025; 13(1):23259671241290320.

PMID: 39758143 PMC: 11694278. DOI: 10.1177/23259671241290320.

Techniques for abductor reattachment in proximal femoral replacement for non-oncological reconstructions: a narrative review.

Innocenti M, Leggieri F, Stimolo D, Carminati M, Christian C, Civinini R Ann Jt. 2024; 9:20.

PMID: 38690077 PMC: 11058535. DOI: 10.21037/aoj-23-26.

Good clinical outcomes, a high level of patient satisfaction and an acceptable re-operation rate are observed 7-10 years after augmented hip abductor tendon repair.

Ebert J, Jain M, Janes G Knee Surg Sports Traumatol Arthrosc. 2023; 31(6):2131-2139.

PMID: 36939865 PMC: 10183414. DOI: 10.1007/s00167-023-07382-3.

Natural History of Degenerative Hip Abductor Tendon Lesions.

Schenk P, Dimitriou D, Rahm S, Zimmermann S, Finsterwald M, Higashigaito K Am J Sports Med. 2022; 51(1):160-168.

PMID: 36412545 PMC: 9810830. DOI: 10.1177/03635465221135759.

Satisfactory results after endoscopic gluteus medius repair combined with selective gluteus maximus reflected tendon release for the treatment of a full-thickness tear of gluteus medius.

Rocca F, Di Francia V, Giuffrida A, Rosolani M, DAmbrosi R, DAddona A Knee Surg Sports Traumatol Arthrosc. 2022; 31(5):2038-2045.

PMID: 36066574 PMC: 10090025. DOI: 10.1007/s00167-022-07140-x.

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