Endoscopic Management of Gluteus Medius Tendon Tears

Sports Med Arthrosc Rev. 2016 Mar;24(1):11-8. doi: 10.1097/JSA.0000000000000082.

Abstract

Tears in the gluteus medius and minimus tendons have been recognized as an important cause of recalcitrant greater trochanteric pain syndrome. Because of the frequency of partial-thickness undersurface tears, this relatively unknown pathology is often misdiagnosed and left untreated. Surgery is indicated in case of 4 associated conditions: (i) Failure of conservative treatment with duration of symptoms >6 months; (ii) magnetic resonance imaging showing a tendon tear; (iii) positive ultrasound-guided infiltration test; and (iv) the absence of an evolved fatty degeneration or atrophy of the gluteus medius and minimus muscle. Endoscopic repair of partial or full-thickness tears, with systematic resection of the bony structures implicated in the impingement, and a complete bursectomy appear to give satisfactory results, although these results remain to be confirmed by clinical studies with longer follow-up. The degree of tendon degeneration may compromise the tissue left for reattachment, raising concerns over its healing capacity, durability, and ultimate strength of the repair.

Publication types

  • Review

MeSH terms

  • Diagnostic Imaging
  • Endoscopy / methods*
  • Hip Joint / surgery*
  • Humans
  • Physical Examination
  • Tendon Injuries / surgery*