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

Abstract Purpose To report national trends, including rates of open vs endoscopic, in hip abductor tendon repair surgery. Methods This retrospective cohort study accessed patient-level insurance claims from adults ≥ 18 years undergoing endoscopic or open gluteal repair from 2016 to 2022 from the IBM ® MarketScan ® Commercial Database and a Medicare sample. The annual repair trends, stratified by insurance database, were described based on five categories: (1) all-cause; (2) proportion of repairs combined with hip arthroscopy or arthroplasty; (3) sex; (4) median age; (5) U.S. region of residence. Results 9217 total repairs across the study period were identified: 4504 in the Commercial and 4713 in the Medicare databases. In both datasets, > 50% of repairs occurred in women and the median patient age was > 50 years. The rate of endoscopic gluteal repairs declined from 2016 to 2022: Commercial (2.7 to 1.5 per 100,000 people) and Medicare (5.1 to 2.1 per 100,000 people). The rate of open gluteal repairs increased from 2016 to 2022: Commercial (0.4 to 1.0 per 100,000 people) and Medicare (1.0 to 2.5 per 100,000 people). The occurrence of gluteal repairs combined with arthroscopy or arthroplasty was rare and did not differ significantly between the two databases. Conclusions 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. These descriptive trends provide insight into national practice patterns for gluteal tendon tear repairs.