EP7.12 Comparative Analysis of Open and Endoscopic Hip Abductor Tendon Repair: Findings from the HipSTR Multicenter Database

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ID: 331036
2026
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Abstract
Abstract Introduction Gluteal tendon tears are a recognized cause of lateral hip pain and functional disability, particularly in middle-aged and older adults, yet optimal surgical management remains debated. Large-scale comparative data informing approach selection and early outcomes are lacking. This study aimed to compare demographics, intraoperative findings, and short-term patient-reported outcome measures (PROMs) between open and endoscopic gluteal tendon repair using a prospective multicenter registry. Methods A retrospective analysis was performed using prospectively collected data from the Hip Surgical Treatment Registry (HipSTR) between February 2023 and March 2025. Adults (≥18 years) undergoing primary or revision open or endoscopic gluteal tendon repair were identified. Demographics, intraoperative variables, and PROMs were compared. Logistic regression identified independent predictors of open repair. Results A total of 171 patients were included (54 open, 117 endoscopic). Open repair patients were older (66.5 ± 9.1 vs. 62.5 ± 11.6 years; P = 0.02) and had higher rates of radiographic osteoarthritis (70.4% vs. 47.9%; P = 0.01). Open repairs trended toward larger anterior-posterior tear dimensions (3.3 ± 1.6 vs. 2.6 ± 1.1 cm; P = 0.054) and utilized more anchors (4.3 vs. 3.5; P = 0.01), double-row fixation (88.9% vs. 58.1%; P = 0.01), and augmentation (65.4% vs. 41.0%; P = 0.01). Both cohorts achieved significant improvements in iHOT-12, SANE, and EQ-5D-VAS scores at 6 and 12 months, with no significant between-group differences. On multivariate logistic regression, higher Milwaukee classification grade independently predicted open repair (P = 0.035), and larger proximal-distal tear size trended toward open repair (OR 2.26; P = 0.051). Conclusion In this multicenter registry cohort, both open and endoscopic gluteal tendon repair yielded comparable early functional outcomes. Open repair was more prevalent among older patients with greater tendon degeneration, reflecting case selection rather than a causal outcome difference. Surgical approach appears primarily driven by patient characteristics and intraoperative pathology. Longer-term follow-up is warranted to evaluate repair durability and re-tear rates. Keywords Gluteal tendon tear; hip abductor repair; arthroscopy; endoscopy; open repair; HipSTR registry; PROMs.
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Authors Yazdan Raji, Majd Mzeihem, Kinsley Pierre, Stephen Kenji Aoki, Olufemi Rolland Ayeni, JW Thomas Byrd, Dominic S. Carreira, T. Sean Lynch, Richard C. “Chad” Mather, Ivan Ho-Bun Wong, Michael B. Banffy, Michael B. Gerhardt, Jorge A. Chahla, Marc Raymond Safran
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.375
URL
https://doi.org/10.1093/jhps/hnag043.375
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