{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T23:56:27Z","timestamp":1785801387948,"version":"3.56.0"},"reference-count":74,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T00:00:00Z","timestamp":1769817600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T00:00:00Z","timestamp":1769817600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The purpose of this systematic review and multilevel meta\u2010analysis was to compare short\u2010term functional outcomes, pain relief, and complication rates between open and endoscopic gluteal tendon repair, expressed as functional improvement normalized to minimal clinically important difference (MCID) units. The hypothesis was that endoscopic repair would provide comparable clinical efficacy with a lower complication rate compared with open repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, Embase, CENTRAL and Epistemonikos were searched to 15 October 2025. Eligible primary studies reporting postoperative or change outcomes were synthesized with a frequentist multilevel random\u2010effects model (inverse variance, restricted maximum likelihood estimation, Hartung\u2013Knapp adjustment).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty\u2010four studies (1278 patients; 1283 hips) met criteria. Postoperative functional MCID (27 studies;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091005): overall 9.01 (95% confidence interval [CI]: 8.11\u20139.91;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u2009100%;\n                      <jats:italic>\u03c4<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20095.2); open 9.09 (8.12\u201310.06; six studies;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009398) versus endoscopic 8.96 (8.02\u20139.90; 17 studies;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009607); no subgroup difference (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.63). Change in functional MCID (21 studies;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009718): overall 3.33 (2.86\u20133.81;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200983%;\n                      <jats:italic>\u03c4<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.9); open 3.10 (2.39\u20133.81; nine studies;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009290) versus endoscopic 3.52 (2.89\u20134.15; 12 studies;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009428); no difference (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.36). Postoperative pain MCID (19 studies;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009867): overall 1.71 (1.27\u20132.16;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200998%;\n                      <jats:italic>\u03c4<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.9); open 1.58 (1.03\u20132.13; nine studies;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009349) versus endoscopic 1.81 (1.31\u20132.32; 11 studies;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009518); no difference (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.38). Change in pain MCID (19 studies;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009798): overall \u20131.99 (\u20132.74 to \u20131.24;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200999%;\n                      <jats:italic>\u03c4<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20092.5); open \u20131.82 (\u20132.96 to \u20130.69; nine studies;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009349) versus endoscopic \u20132.12 (\u20133.18 to \u20131.09; 11 studies;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009449); no difference (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.68). Overall complications (25 studies;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009804): 58\/804 (0.07; 95% CI: 0.05\u20130.11;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200953%;\n                      <jats:italic>\u03c4<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.8); open 33\/371 (0.08; 0.04\u20130.16) versus endoscopic 25\/433 (0.07; 0.04\u20130.12); no difference (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.70).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Open and endoscopic gluteal tendon repair provide clinically meaningful short\u2010term improvements in function and pain, with no relevant differences in efficacy when interpreted using MCID units. These findings support both techniques in clinical practice and favour endoscopic repair when available due to its less invasive nature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, systematic review and meta\u2010analysis of predominantly Level III studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70309","type":"journal-article","created":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T11:52:28Z","timestamp":1769860348000},"page":"1061-1080","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Endoscopic gluteal tendon repair reduces complication rates while achieving outcomes comparable to open repair: A multilevel meta\u2010analysis"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4669-8187","authenticated-orcid":false,"given":"Nikolai","family":"Ramadanov","sequence":"first","affiliation":[{"name":"Center of Orthopaedics and Traumatology, Brandenburg Medical School University Hospital Brandenburg an der Havel Brandenburg an der Havel Germany"},{"name":"Faculty of Health Science Brandenburg, Brandenburg Medical School Theodor Fontane Brandenburg an der Havel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Voss","sequence":"additional","affiliation":[{"name":"Center of Orthopaedics and Traumatology, Brandenburg Medical School University Hospital Brandenburg an der Havel Brandenburg an der Havel Germany"},{"name":"Faculty of Health Science Brandenburg, Brandenburg Medical School Theodor Fontane Brandenburg an der Havel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariana","family":"Lott","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery NYU Langone Orthopedic Hospital New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Hable","sequence":"additional","affiliation":[{"name":"Faculty of Applied Computer Science, Deggendorf Institute of Technology Deggendorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Prill","sequence":"additional","affiliation":[{"name":"Center of Orthopaedics and Traumatology, Brandenburg Medical School University Hospital Brandenburg an der Havel Brandenburg an der Havel Germany"},{"name":"Faculty of Health Science Brandenburg, Brandenburg Medical School Theodor Fontane Brandenburg an der Havel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Becker","sequence":"additional","affiliation":[{"name":"Center of Orthopaedics and Traumatology, Brandenburg Medical School University Hospital Brandenburg an der Havel Brandenburg an der Havel Germany"},{"name":"Faculty of Health Science Brandenburg, Brandenburg Medical School Theodor Fontane Brandenburg an der Havel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marko","family":"Ostojic","sequence":"additional","affiliation":[{"name":"Sports Traumatology Division, Traumatology Department Draskoviceva University Hospital \u2018Sestre Milosrdnice\u2019 Zagreb Croatia"},{"name":"Osteon Orthopedics and Sports Medicine Clinic Mostar Bosnia and Herzegovina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Plamen","family":"Penchev","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Medical University of Plovdiv Plovdiv Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingo J.","family":"Banke","sequence":"additional","affiliation":[{"name":"Clinic of Orthopaedics and Sports Orthopaedics, School of Medicine and Health TUM University Hospital, Technical University of Munich Munich Germany"},{"name":"AGA\u2010Society for Arthroscopy and Joint\u2010Surgery, Hip Committee, c\/o Walder Wyss Ltd. 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