EP7.17 Hip Abductor Reconstruction with Human Dermal Allograft Shows Promising Outcomes and Increased Tendon Thickness at Short-Term Follow-Up

Abstract Background Hip abductor tendon tears, particularly involving the gluteus medius and minimus, are an increasingly recognized source of lateral hip pain and functional limitation. These injuries are often associated with degenerative changes and may be challenging to manage, especially in chronic or revision cases where tissue quality is compromised. Open abductor reconstruction with acellular human dermal allograft has emerged as a potential surgical option to augment repair and improve structural integrity. Methods Patients who underwent abductor reconstruction with human dermal allograft between December 2018 to August 2023 and with ≥2-year follow-up were included. Preoperative patient reported outcomes (PROs) assessed included 12-item International Hip Outcome Tool (iHOT-12), Patient-Reported Outcomes Measurement System Pain Interference (PROMIS-PI), and PROMIS-Physical Function (PROMIS-PF). Postoperatively, Hip Outcome Score Activities of Daily Living (HOS-ADL) and Hip Outcome Score Sport Specific Subscale (HOS-SS) were also obtained. Achievement of minimal clinically important difference (MCID), patient acceptable symptom state (PASS), clinical failure, and reoperation rates were assessed. Results Twenty-three hips were included in the present study. At minimum 2 years, there was a significant improvement in iHOT-12 (34.9±18.5 vs. 61.9±29.2; P <.001), PROMIS-PI (64.0±7.0 vs. 55.6±11.0; P =.006), and PROMIS-PF (37.5±6.0 vs. 42.7±9.0; P=.008). Postoperative HOS-ADL and HOS-SS were 70.7±26.9 and 50.9±34.3, respectively. Achievement of MCID amongst individual PROs was 52.9%-66.7% and 80.0% for any PRO. PASS achievement amongst PROs ranged from 35.0%-59.1%, and for any PRO was 68.2%. There was a significant increase in combined gluteus medius and minimus tendon thickness from preoperative to mean 2.8 years follow-up (7.6±1.8 mm vs. 10.5±1.8 mm; P<.001). The clinical failure rate was 4.4% and the reoperation rate was 4.4%. Conclusions Open abductor tendon repair with dermal allograft augmentation resulted in significant clinical improvement and a low failure rate at minimum 2-year follow-up, even in a cohort characterized by advanced degenerative pathology and a high proportion of revision cases. Patients demonstrated meaningful improvements in patient-reported outcomes, high rates of MCID and PASS achievement, and evidence of increased tendon thickness, suggesting potential structural benefit.