Abstract
Background and Objectives: Partial gluteal tendon tears in native hips are often misdiagnosed as greater trochanteric pain syndrome, resulting in ineffective conservative treatment and persistent symptoms. Although surgical repair techniques exist, data on objective strength outcomes in non-arthritic hips remain limited. The objective of this study was to evaluate pain reduction, patient-reported outcomes (PROMs), and isometric hip abductor strength following mini-open, knotless double-row repair using the Hip Bridge technique. Material and Methods: This retrospective, single-center cohort study (Level III) with prospective outcome evaluation included 27 patients (mean age 53 years, BMI 27 kg/m(2)) with partial gluteal tendon tears and no advanced osteoarthritis (Tönnis grade ≤ 1), treated between 2015 and 2022 using the mini-open, knotless double-row Hip Bridge technique. The mean follow-up was 29.3 ± 24.3 months (minimum 6 months). Diagnosis was confirmed by 3-Tesla MRI, and other sources of lateral hip pain were excluded. Clinical outcomes included the Visual Analog Scale (VAS), modified Harris Hip Score (mHHS), Hip Outcome Score (HOS), normalized Western Ontario and McMaster Universities Osteoarthritis Index (nWOMAC), and Copenhagen Hip and Groin Outcome Score (HAGOS). Isometric hip abductor strength was assessed in 22 patients using a dynamometer, comparing the operated and contralateral limbs. Results: Postoperative satisfaction was high: 93% would undergo surgery again, 88% reported improved Trendelenburg gait, and 85% noted subjective strength gains. Pain improved significantly from VAS 8 (range, 3 to 10) preoperatively to VAS 2 (range, 0 to 7) postoperatively (p < 0.001); 100% reported pain relief. Patient-reported outcome scores were mHHS, 84.2; nWOMAC, 86.5; HOS, 80.7; and HAGOS, 70.7. Isometric strength testing showed significant improvement on the operated side (Fmax: p = 0.006; Fmean: p = 0.009). The mean limb symmetry index was 118% for Fmax and 122% for Fmean. Conclusions: Mini-open, knotless double-row repair of partial gluteal tears in non-arthritic hips yields adequate pain relief, high satisfaction, and objective strength recovery. The Hip Bridge technique could be an effective option after failed conservative treatment. Future prospective comparative studies are warranted to validate mid-term outcomes and establish long-term efficacy.