2025 ISAKOS Biennial Congress ePoster
Endoscopic Treatment of Gluteus Medius Tear with Bioinductive Implant: Portals Decription and Surgical Technique
Jose Felix Castillo Saenz, MD, Panama, Panama PANAMA
Dante Parodi, MD, Santiago CHILE
Emilio Jose Tufiño, MD, Ciudad De Panama, Panama PANAMA
Daniela Seidel, MD MEXICO
The Panama Clinic - Centro Ortopedico Panama Clinic, Panama City, Panama, PANAMA
FDA Status Cleared
Summary
Approach to the peritrochanteric space for the repair and augmentation of gluteus medius tears with a bioinductive implant, greater trochanter microperforations and limited proximal insertion realease of the gluteus major muscle.
ePosters will be available shortly before Congress
Abstract
Lesions of the hip abductor mechanism in the peritrochanteric space can range from traumatic to degenerative. Traumatic injuries, more common in young adults, are often managed with direct repair using suture anchors, which generally have a high rate of healing due to the better biology and quality of the injured tendons. Conversely, degenerative lesions, more prevalent in older adults with chronic conditions such as enthesopathy or calcific tendinitis, may have higher failure rates with suture anchor repairs due to the suboptimal quality of the tendons and reduced vascularity for effective healing. In addition to the tendinous injury, the symptoms of lateral hip pain involve a condition of lateral hyperpressure characterized by thickening of the iliotibial band, development of adhesions, and fibrosis of the trochanteric bursa, which make conservative treatment less effective for these patients.
In such cases, augmentation with a biological membrane can enhance the likelihood of successful healing and reduce the rate of re-ruptures compared to conventional repairs.
In this manuscript, we aim to demonstrate our technique for the repair and augmentation of the gluteus medius tendon using a bioinductive implant. To enhance cellular contribution to the lesion area, we perform microperforations of the greater trochanter to facilitate stem cell migration into the peritrochanteric space and the repair area. Additionally, we release the proximal 3 cm of the gluteus major insertion to decompress the peritrochanteric space and assess the hyperpressure component, releasing adhesions and minimize the friction of the iliotibial band on the greater trochanter, thereby protecting both the implant and the tendon repair. This will preserve the integrity of the iliotibial band and does not affect the function of the gluteus major if performed correctly. We will describe our endoscopic approach, portal placement, and surgical technique, as well as our postoperative protocol for these patients.