Gluteus medius tendon dysfunction and tears

Gluteus Medius Tendon Dysfunction and Tears

• symptomatic tendinosis and tears of the gluteus medius/ minimus insertion on the greater trochanter - similar to a tear of the insertion of the rotator cuff
  • presentation is with dull lateral hip pain
    • frequently aggravated by weightbearing and resisted abduction
• tears of the gluteus medius and minimus may be a common cause of recalcitrant lateral trochanteric pain
  • tears of the hip abductors may be interstitial or partial/full thickness
    • partial tears are most common
• investigation
  • MRI or ultrasound
    • useful to evaluate the integrity of the abductor tendon insertion on the greater trochanter

Treatment

• generally conservative
  • modification of activity, massage, ice, stretching
  • corticosteroid injections may provide relief
• surgical treatment
  • considered only in refractory cases
    • open techniques for tendon repair- provide excellent symptomatic relief
    • arthroscopic techniques have been shown to provide pain relief and improvement in strength

Reference:

• Grumet RC et al. Lateral Hip Pain in an Athletic Population: Differential Diagnosis and Treatment Options.Sports Health 2010; 2(3): 191-6.
• Connell DA et al. Sonographic evaluation of gluteus medius and minimus tendinopathy. Eur Radiol. 2003;13(6):1339-1347.