Labral tears and chondral lesions are common comorbidities identified during endoscopic repair of gluteal tendon tears for greater trochanteric pain syndrome: A systematic review.

PURPOSE: The primary purpose of this study was to systematically review the literature on intraoperative findings during endoscopic treatment for GTPS. Secondary outcomes were preoperative imaging findings and postoperative functional outcome measures.

METHODS: Medline, PubMED, and Embase databases were searched from inception (1946, 1966, 1974 respectively), to July 15, 2021 for records reporting intraoperative findings during endoscopic surgery for GTPS. Studies of level I-IV evidence were eligible. All studies were assessed for quality using the Methodological Index for Non-Randomized Studies (MINORS) score.

RESULTS: Sixteen studies met the inclusion criteria. Most patients underwent endoscopic greater trochanteric bursectomy with repair of the gluteal tendons. Intraoperative conditions reported were gluteal tendon tears usually involving the gluteus medius tendon, labral tears, and chondral lesions. Three studies reported an average of 9% of patients who subsequently underwent conversion to total hip arthroplasty. Pain was assessed using VAS, and functional outcome measures were measured using the mHHS, NAHS, HOS-SS and HOS-ADL, and iHOT-12. Pain and functional outcomes demonstrated significant improvement in nearly all the studies where they were reported.

CONCLUSIONS: Patients who underwent endoscopic management of GTPS commonly underwent repair of gluteal tendon tears, and in many cases had concomitant labral tears and chondral lesions identified intraoperatively. There were low rates of adverse events, repair failure, and revision surgery. Patient-reported functional outcomes were improved at follow-up at least one year postoperatively.