Primary Total Hip Arthroplasty With Concomitant Gluteus Medius Repair: Mid-term Outcomes With Nested Propensity-Matched Benchmark Control.

Background: Patients who undergo total hip arthroplasty (THA) without addressing gluteus medius (GM) pathology tend to experience inferior outcomes. The study aims to evaluate mid-term outcomes in patients who underwent a primary THA with concomitant GM tear repair, as compared to a benchmark control group of primary THA patients that did not have GM pathology. Methods: Data were retrospectively analyzed from patients who underwent a primary THA with a concomitant GM repair between 2015 and 2018. Included patients completed preoperative and minimum 5-year questionnaires for Harris Hip Score, visual analog scale, Veteran's Rand 12-item (VR-12) health survey, 12-item Short Form (SF-12) heath surveys, Forgotten Joint Score, and the Hip Disability and Osteoarthritis Outcome Score for Joint Replacement. The GM cohort was matched in a 1:3 ratio based on age at surgery, body mass index, sex, approach, and robotic-assisted surgery to a control group of primary THAs without GM pathology. Thresholds for functional outcomes were included. Results: Forty patients who underwent primary THA with GM repair were included successfully match to 120 control patients. There were significant improvements in the reported Harris Hip Score, visual analog scale, VR-12 Physical, VR-12 Mental, SF-12 Physical, and SF-12 Mental scores in the study group. Despite their gluteus medius pathology, with concomitant repair, the study group achieved patient-reported outcomes improvements and rates of minimal clinically important difference and patient acceptable symptom state that were comparable to the control group. Conclusions: THA with concomitant GM repair yielded significant improvement in functional status and clinical outcomes, which compared favorably to a benchmark control group without GM tears. Surgeons may consider addressing GM tears during a primary THA. Level of Evidence: Level III.