Gluteus Maximus Transfer for Irreparable Hip Abductor Tendon Tears: Technique and Clinical Outcomes

Hip abductor tears are increasingly recognized as a common source of lateral hip pain. Primary repair has generally shown excellent results. However, where repair is not possible or advanced muscle atrophy is present, few reconstructive options are available. Here we present the technique and results of a simplified method for transfer of the gluteus maximus tendon to the greater trochanter. Patients undergoing gluteus maximus tendon transfer were identified from our institution hip preservation registry. Electronic health records, imaging, and clinical examination findings were recorded for each patient and analyzed. Preoperative and postoperative patient-reported outcome scores were also collected for each patient including the modified Harris Hip Score (mHHS), Hip Outcome Score-Activity of Daily Living Scale (HOS-ADL), Hip Outcome Score-Sports Scale (HOS-S), and the International Hip Outcome Tool (iHOT-33). Six patients met inclusion criteria. All patients exhibited a Trendelenburg gait before surgery, and mean hip abduction strength preoperatively was 3.8/5. At final clinical follow-up, all patients had 5/5 hip abduction strength on manual muscle testing. No patient experienced a surgical complication. Three of the 6 patients had complete resolution of their Trendelenburg gait. At mean 3.8 years follow-up, mean improvement in HOS-ADL was 16.91, HOS-Sport = 24.71, mHHS = 18.42, and iHOT-33 = 42.74.