FP13.3 Trends in Endoscopic and Open Hip Abductor Tendon Repairs: An Insurance Claims-Based Analysis from 2016 to 2022

Abstract ICLB13 - Outside the Joint: Mastering Extra-Articular Pain and Hip-Spine Basics, Session Room 6 (BMCC Level 3), October 9, 2026, 14:00 - 16:00 Introduction Despite increasing clinical and research interest in the repair of gluteus medius and minimus (hip abductor) tendons, national trends in hip abductor tendon repair, including rates of open vs. endoscopic approaches, have not been reported. The primary aim of this investigation was to characterize the temporal trends of endoscopic vs. open hip abductor tendon repair, along with trends in patient demographics and concomitant procedures. Methods This retrospective cohort study accessed patient-level insurance claims from adults ≥18 years undergoing endoscopic or open gluteal repair from 2016-2022 from the IBM® MarketScan® Commercial Database and a Medicare sample. The annual trends, stratified by insurance database, of endoscopic and open gluteal repairs were described based on five categories: (1) all-cause repairs; (2) the proportion of isolated repairs or those combined with hip arthroscopy or arthroplasty; (3) sex; (4) median age; (5) U.S. region of residence. Results 9,217 total repairs across the study period were identified: 4,504 in the Commercial and 4,713 in the Medicare databases. In both datasets, >50% of repairs occurred in women, the median patient age was >50 years old, and the greatest proportion of operations were performed in the Southern region of the United States: 42.3% (Commercial) and 36.1% (Medicare). The rate of endoscopic gluteal repairs declined from 2016 to 2022 in the Commercial database (2.7 to 1.5 per 100,000 people) and the Medicare database (5.1 to 2.1 per 100,000 people). The rate of open gluteal repairs increased from 2016 to 2022 in the Commercial (0.4 to 1.0 per 100,000 people) and the Medicare (1.0 to 2.5 per 100,000 people) databases. The occurrence of gluteal repairs in combination with arthroscopy or arthroplasty was rare and did not differ significantly between the two databases. Conclusion Hip abductor tendon repairs were most performed in women and in patients over the age of 50. Across both the commercial and Medicare database, the rate of endoscopic tendon repairs decreased from 2016 to 2022 while open repairs increased. Open repairs were more commonly associated with concomitant procedures. These descriptive trends provide insight into national practice patterns for hip abductor tendon repairs.