EP6.9 Open versus endoscopic hip abductor repair: a systematic review and meta-analysis

Introduction: Hip abductor tendinopathy is a common cause of lateral hip pain and is often accompanied by a pronounced limp and pain with single leg stance. In cases where conservative management fails, surgical interventions have been described utilizing both open and endoscopic techniques. Numerous studies have sought to determine the superiority of either approach, however no consensus has been reached at present. A systematic review and meta-analysis was conducted to compare complication profiles and patient reported outcomes between open and endoscopic repairs of hip abductor tendons.

Methods: Systematic review and meta-analysis was conducted according to standard protocols and with the assistance of an experienced librarian. Patients were stratified by the surgical technique (open or endoscopic). Outcomes assessed included multiple patient reported outcome metrics and rates of various complications. A two-tailed T-test was utilized for analysis of continuous variables. Cohen’s effect size was utilized to assess the pooled effect size, 95% confidence intervals, heterogeneity and homogeneity.

Results: Following initial search, a total of 393 manuscripts were identified. After exclusion criteria and manuscript review a total of 43 manuscripts were included for final data extraction. There were 24 manuscripts reporting outcomes from open procedures, 20 reporting outcomes from endoscopic procedures. One manuscript included both open and endoscopic techniques, however outcomes were divided by surgical technique. Of the patients included in these studies, 87.5% were female with a mean age of 62.1 years old, and a mean body mass index of 27.9. There was no significant difference in any complication rates between surgical approaches. There was no significant difference in any PROM utilized. Patients reported significant improvement regardless of surgical approach, with pain visual analog scores improving from a mean of 7.3 to 2.2 in open cases and from 6.8 to 2.6 in endoscopic cases.

Conclusions: Patients undergoing either open or endoscopic repair of gluteal tendon injuries show significant improvement with no surgical approach demonstrating statistically superiority either in regards to complication rates or multiple patient reported outcome metrics.