EP7.2 Endoscopic Repair of Degenerative Gluteus Medius Tendinopathy with Bioinductive Collagen Implant: Mid - to Long-Term Outcomes

Abstract Background Degenerative gluteus medius tendinopathy is a prevalent and often treatment-resistant condition disproportionately affecting women. Although open repair has historically been the preferred surgical approach, endoscopic repair has gained increasing interest in the management of these lesions, with outcomes potentially influenced by the compromised tendon biology inherent to degenerative tissue. Bioinductive collagen implants have emerged as a promising adjunct to enhance biological healing; however, evidence supporting their use in hip abductor pathology remains limited. This study evaluates mid- to long-term clinical outcomes following endoscopic gluteus medius repair augmented with a bovine bioinductive collagen implant in an all-female cohort. Methods We conducted a prospective cohort study of 58 consecutive female patients who underwent endoscopic repair of degenerative gluteus medius tendinopathy with bioinductive implant augmentation between 2019 and 2025. All patients had failed at least 6 months of conservative management. Two patients presented with persistent lateral hip pain following total hip arthroplasty performed via a lateral approach. All procedures followed a standardized endoscopic technique. Patient-reported outcomes included the modified Harris Hip Score (mHHS), iHOT-12, and Visual Analog Scale (VAS) for pain. Clinical relevance was assessed using the Minimal Clinically Important Difference (MCID) and Patient Acceptable Symptom State (PASS). Follow-up ranged from 6 months to 6 years. Results Patients demonstrated significant and sustained improvements across all outcome measures at final follow-up. The mean patient age was 61 ± 2 years (range, 44–78). Overall, 90% (52/58) of patients achieved the MCID for VAS, mHHS, and iHOT-12, with 85% and 82% reaching PASS thresholds for mHHS and iHOT-12, respectively. Substantial pain reduction was accompanied by meaningful functional recovery and improved quality of life, with most patients returning to unrestricted daily activities. Importantly, outcomes were maintained at extended follow-up intervals, suggesting durability of the repair construct. No major complications or implant-related adverse events were recorded. The two patients with prior hip arthroplasty also achieved favorable outcomes, underscoring the applicability of this technique in complex clinical scenarios. Conclusion Endoscopic repair of degenerative gluteus medius tendinopathy augmented with a bioinductive collagen implant yields reproducible, clinically meaningful, and durable outcomes in a high-risk female population. Representing one of the largest prospective cohorts with mid- to long-term follow-up reported to date, this study provides compelling evidence that biological augmentation can effectively address the intrinsic healing limitations of degenerative tendon tissue. These findings support a potential paradigm shift in gluteal tendon repair, positioning bioinductive implants as a valuable tool — and possibly a new standard of care — in patients with compromised tissue quality.