PMID- 37207918
OWN - NLM
STAT- MEDLINE
DCOM- 20240202
LR  - 20240226
IS  - 1526-3231 (Electronic)
IS  - 0749-8063 (Linking)
VI  - 40
IP  - 2
DP  - 2024 Feb
TI  - The Gluteus-Score-7 Predicts the Likelihood of Both Clinical Success and Failure 
      Following Surgical Repair of the Hip Gluteus Medius and/or Minimus.
PG  - 343-351.e4
LID - S0749-8063(23)00393-6 [pii]
LID - 10.1016/j.arthro.2023.03.035 [doi]
AB  - PURPOSE: To identify patient preoperative history, examination, and imaging 
      characteristics that increase the risk of postoperative failure of gluteus 
      medius/minimus repair, and to develop a decision-making aid predictive of 
      clinical outcomes for patients undergoing gluteus medius/minimus repair. METHODS: 
      Patients from 2012 to 2020 at a single institution undergoing gluteus 
      medius/minimus repair with minimum 2-year follow-up were identified. MRIs were 
      graded according to the "three-grade" classification system: grade 1: 
      partial-thickness tear, grade 2: full-thickness tears with <2 cm of retraction, 
      grade 3: full-thickness tears with >/=2 cm retraction. Failure was defined as 
      undergoing revision within 2 years postoperatively or not achieving both a 
      cohort-calculated minimal clinically important difference (MCID) and responding 
      "no" to patient acceptable symptom state (PASS). Inversely, success was defined 
      as reaching both an MCID and responding "yes" to PASS. Predictors of failure were 
      verified on logistic regression and a predictive scoring model, the 
      Gluteus-Score-7, was generated to guide treatment-decision making. RESULTS: In 
      total, 30 of 142 patients (21.1%) were clinical failures at mean +/- SD follow-up 
      of 27.0 +/- 5.2 months. Preoperative smoking (odds ratio [OR], 3.0; 95% confidence 
      interval [CI], 1.0-8.4; P = .041), lower back pain (OR, 2.8; 95% CI, 1.1-7.3; P = 
      .038), presence of a limp or Trendelenburg gait (OR, 3.8; 95% CI, 1.5-10.2; P = 
      .006), history of psychiatric diagnosis (OR, 3.7; 95% CI, 1.3-10.8; P = .014), 
      and increased MRI classification grades (P </= .042) were independent predictors of 
      failure. The Gluteus-Score-7 was generated with each history/examination 
      predictor assigned 1 point and MRI classes assigned corresponding 1-3 points (min 
      1, max 7 score). A score of >/=4/7 points was associated with risk of failure and a 
      score </=2/7 points was associated with clinical success. CONCLUSIONS: Independent 
      risk factors for revision or not achieving either MCID or PASS after gluteus 
      medius and/or minimus tendon repair include smoking, preoperative lower back 
      pain, psychiatric history, Trendelenburg gait, and full-thickness tears, 
      especially tears with >/=2 cm retraction. The Gluteus-Score-7 tool incorporating 
      these factors can identify patients at risk of both surgical treatment failure 
      and success, which may be useful for clinical decision-making. LEVEL OF EVIDENCE: 
      Level IV, prognostic case series.
CI  - Copyright (c) 2023 Arthroscopy Association of North America. Published by Elsevier 
      Inc. All rights reserved.
FAU - Allahabadi, Sachin
AU  - Allahabadi S
AD  - Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of 
      Orthopedic Surgery, Rush Medical College of Rush University, Rush University 
      Medical Center, Chicago, Illinois, U.S.A.
FAU - Chapman, Reagan S
AU  - Chapman RS
AD  - Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of 
      Orthopedic Surgery, Rush Medical College of Rush University, Rush University 
      Medical Center, Chicago, Illinois, U.S.A.
FAU - Fenn, Thomas W
AU  - Fenn TW
AD  - Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of 
      Orthopedic Surgery, Rush Medical College of Rush University, Rush University 
      Medical Center, Chicago, Illinois, U.S.A.. Electronic address: 
      nho.research@rushortho.com.
FAU - Browning, Robert B
AU  - Browning RB
AD  - Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of 
      Orthopedic Surgery, Rush Medical College of Rush University, Rush University 
      Medical Center, Chicago, Illinois, U.S.A.
FAU - Nho, Shane J
AU  - Nho SJ
AD  - Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of 
      Orthopedic Surgery, Rush Medical College of Rush University, Rush University 
      Medical Center, Chicago, Illinois, U.S.A.
LA  - eng
PT  - Journal Article
DEP - 20230518
PL  - United States
TA  - Arthroscopy
JT  - Arthroscopy : the journal of arthroscopic & related surgery : official 
      publication of the Arthroscopy Association of North America and the International 
      Arthroscopy Association
JID - 8506498
SB  - IM
MH  - Humans
MH  - *Low Back Pain/surgery
MH  - Muscle, Skeletal/surgery
MH  - Buttocks/surgery
MH  - Risk Factors
MH  - *Plastic Surgery Procedures
EDAT- 2023/05/20 09:42
MHDA- 2024/02/02 06:43
CRDT- 2023/05/19 19:26
PHST- 2023/02/07 00:00 [received]
PHST- 2023/02/20 00:00 [revised]
PHST- 2023/03/19 00:00 [accepted]
PHST- 2024/02/02 06:43 [medline]
PHST- 2023/05/20 09:42 [pubmed]
PHST- 2023/05/19 19:26 [entrez]
AID - S0749-8063(23)00393-6 [pii]
AID - 10.1016/j.arthro.2023.03.035 [doi]
PST - ppublish
SO  - Arthroscopy. 2024 Feb;40(2):343-351.e4. doi: 10.1016/j.arthro.2023.03.035. Epub 
      2023 May 18.