ISAKOS Congress 2021

2021 ISAKOS Biennial Congress ePoster

 

Evaluation of endoscopically gluteus medius repair in patients with Femoro-acetabular impingement and labrum detachment

George D. Tsikouris, MD, Athens, Kolonaki GREECE
Nikolaos D. Gravvanis, MD, Athens, Attica GREECE
Georgia S. Dedousi, MD, Athens, Attica GREECE
Panagiota Vlaserou, BSc in Physiotherapy, MSc Biomedical Engineer, Athens, Ilioupoli GREECE
Fanis P. Papadakis, BSc, MSc(cand.), Athens, Attiki GREECE
Ioannis K. Antonopoulos, Athens GREECE
Vassilis N. Psychoyios, MD, Athens, Attica GREECE
Theodoros G. Troupis, Prof, Athens, Attica GREECE

Athens Kolonaki Kalamata Orthopaedic & Sports Medicine Institute, Athens, Attica, GREECE

FDA Status Not Applicable

Summary

Evaluation of endoscopically gluteus medius repair in patients with Femoro-acetabular impingement and labrum detachment

ePosters will be available shortly before Congress

Abstract

Evaluation of endoscopically gluteus medius repair in patients with Femoro-acetabular impingement and labrum detachment
Tsikouris D. Georgios1, 2 ,Gravvanis D. Nikolaos1 ,Dedousi S. Georgia1,Vlasserou V. Panagiota5, Papadakis P. Theofanis1, Antonopoulos Ioannis4, Psychoyios N. Vasilios3 , Troupis G. Theodoros6

1. Athens Kolonaki Kalamata Orthopaedic & Sports Medicine Institute (AKKOSMI)
2.Doctor for International Weightlifting Federation
3.Director 5thOrthopaedic Clinic General Hospital “Asklipieio” Voulas Athens
4.Anatomy Department Athens Medical School
5.Physiotherapist , Body Recovery & Health
6.Professor of Anatomy Department, Athens Medical School

Materials: The decreased performance and residual pain due to hip injury refractory to conservative treatment, can be addressed and treated appropriately with hip arthroscopy and endoscopic gluteus medius repair at the peritrochanteric area.

Purpose

To evaluate hip endoscopy at the peritrochanteric area for gluteus medius repair

Methods

From March 2015 to January 2019, 15 patients (4 males, 11 females; mean age 55 years) with gluteus medius tear underwent hip arthroscopy and endoscopy at the peritrochanteric area in our practice and were retrospectively studied. There was a 3 to 6 months period between the deterioration of symptoms which caused diminished daily activities and disability, and the surgery. Imaging studies included MRI arthrography, as well as AP pelvic, cross-table lateral and false-profile view radiographs. A muscoskeletal ultrasound was also used for assessing FAI, labral detachment, calcification and gluteus medius tear. Definite diagnosis was made intra-operatively.
The Modefied Harris Hip Score was used as an assessment tool and a hip screening including impingement sign, Dial Test, FABER, resisted AB crunch, Tredelenburg sign, 1 week prior to surgery and at the 12th post-op week. All participants followed similar post-operative rehabilitation protocol in our clinic with special modifications for the patients with cartilage lesions.

Results

Labral detachment and FAI were present in all patients whereas 5/15 had additional cartilage defects. All of themhad gluteus medius tear (9 right, 6 left hips) and 13/15 also had labral pathology. Labrum repair was performed using bio-absorbable anchors and FAI lesions were excised using the burr. Subchondral bone micro-fractures were operated in subjects with cartilage lesions.
The mean pre-op modified Harris Hip Score was 50 and improved to 82 at 12 weeks post-op indicationg very goof results. 12/25 patients were completely pain-free and returned to full activity at 12 weeks. 3/15 had residual pain due to iliopsoas tendinitis, weakness of the hip abductors and returned to an improved level of activity between 15-18 weeks. 2/15 developed long-term heterotopic ossification.

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