Asymptomatic Gluteal Tendinosis Does Not Adversely Affect Outcomes of Primary Total Hip Arthroplasty

J Arthroplasty. 2023 Dec;38(12):2638-2643. doi: 10.1016/j.arth.2023.05.076. Epub 2023 Jun 5.

Abstract

Background: The aim of this study was to compare outcomes after total hip arthroplasty (THA) in patients who have preoperative asymptomatic gluteal tendinosis (aGT) to a control group with no gluteal tendinosis (GT).

Methods: A retrospective analysis was performed using data from patients who underwent THA between March 2016 and October 2020. An aGT was diagnosed using hip magnetic resonance imaging (MRI) without clinical symptoms. Patients who had aGT were matched (1:1) to patients without GT on MRI. A total of 56 aGT hips and 56 hips without GT were found using propensity-score matching. Patient-reported outcomes, intraoperative macroscopic evaluation, outcome measurements, postoperative physical examinations, complications, and revisions were compared for both groups.

Results: When compared to preoperative outcomes, both groups demonstrated significant improvements in patients-reported outcomes at the final follow-up. There were no significant differences between both groups for preoperative scores, 2-year postoperative outcome scores, or the magnitude of improvement. Patients in the aGT group were significantly less likely to obtain the MCID for the SF-36 MCS score (50.2 versus 69.3%, P = .034). However, there were no other differences in the rates of meeting the MCID between both groups. The aGT group demonstrated significantly higher rates of partial tendon degeneration of the gluteus medius muscle.

Conclusion: Asymptomatic gluteal tendinosis patients who have osteoarthritis and undergo THA may expect favorable patients-reported outcomes at minimum 2-year follow-up. These results were comparable with those of a control group of patients without gluteal tendinosis.

Level of evidence: III.

Keywords: asymptomatic gluteal tendinosis; hip abductors; osteoarthritis; patient-reported outcomes; primary total hip arthroplasty.

MeSH terms

  • Arthroplasty, Replacement, Hip* / methods
  • Hip Joint / diagnostic imaging
  • Hip Joint / surgery
  • Humans
  • Muscle, Skeletal / surgery
  • Patient Reported Outcome Measures
  • Retrospective Studies
  • Tendinopathy* / surgery
  • Tendons / surgery
  • Treatment Outcome