Gluteus Medius Repair using a Gluteus Maximus Flap Augmented with Synthetic Polyethylene Mesh: Surgical Technique and Case Series

• Published in: Orthopedic Reviews 2022-08, Vol.14 (3), p.31904-31904
• Main Authors: Jimenez-Telleria, Iñigo, Foruria, Xabier, Moreta, Jesús, Bernuy, Lucia, Casado, Oscar, Martinez-de los Mozos, José Luis
• Format: Article
• Language: English
• Subjects: Case Reports
• ISSN: 2035-8164; 2035-8237; 2035-8164
• DOI: 10.52965/001c.31904

IntroductionGluteus medius tendon tears may not be feasible for direct repair when significant retraction or fatty degeneration is present. Several augmentation techniques have been reported for challenging cases. We describe a novel technique using a transfer of the anterior portion of the gluteus maximus combined with synthetic mesh to reinforce the direct suture of the gluteus medius. The goal of this study was to assess the functional and pain outcomes in three patients treated with this reconstruction technique. Case presentationA retrospective study was performed including 3 patients with complete and retracted ruptures of the abductor mechanism. When conservative management failed, surgical treatment was attempted. After a minimum follow-up of 12 months (mean follow-up of 18 months), all of the patients showed clinical improvement.The mean Harris Hip Score improved from 31.8 to 75.6, with an average postoperative abduction strength of 3 in the Medical Research Council muscle strength grading system, and no residual limp was noticed. The mean Visual Analogue Scale pain score decreased from 8.3 preoperatively to 1.6 postoperatively. No complications were reported. ConclusionIn conclusion, this technique demonstrates efficacy in terms of improving clinical symptoms and functional status and is a reproducible way to augment irreparable gluteus medius tears.