Gluteus Medius Repair
What is the gluteus medius?
The gluteus medius is a major muscle on the outside of the hip connecting the pelvis to the thighbone (femur) with its tendon. It is responsible for stabilizing the hip allowing us to stand up, walk and run by controlling the tilt of the pelvis. Specifically, it helps move the leg away from the body (abduction) with the hip in neutral or internally rotate the hip when in flexion. Injury to this muscle can lead to pain and instability in the hip, making it difficult to walk or even stand.
Damage can occur from playing sports like basketball, football, or distance running from a fall or direct blow to the area. However, most commonly, gluteus medius damage is typically caused by an overuse injury that results in severe muscle strain, which thereby creates chronic inflammation and eventual tearing of the tendon. Gluteus medius tendon tears often occur at its attachment on the side of the hip. The muscle may be partially or completely torn off the bone.
Degenerative nontraumatic tears are often found in patients over the age of fifty who are diagnosed with greater trochanteric pain syndrome (GTPS) characterized by chronic inflammation (bursitis) along the side of the hip, as well as gluteus medius tendon tears.
Gluteus medius tendon tears are a well-established source of pain and disability. Symptoms may include limping or pain to touch that worsens with activity or lying on the affected side at night. Often times, patients present with a painful gait pattern or even hip drop when attempting to stand or walk.
The expert team at LALL Orthopedics+ will ask about your symptoms and review your medical history. They will perform a focused orthopedic exam evaluating your gait, areas of tenderness, ranges of hip motion and gluteus medius muscle strength. This exam will help him determine the exact area and amount of damage. They will order X-Ray and MRI imaging for an accurate diagnosis based on published classification systems developed by Dr Lall. Classifying the injury pattern will help determine the optimal treatment option.
Treatment for gluteus medius damage will depend on the severity of the injury. Most cases will improve with conservative management including rest and icing, activity modification, anti-inflammatory medications, and physical therapy.
When there is a complete, full-thickness tendon tear, or when non-operative measures have been exhausted without resolution of symptoms and return of hip function, our team will recommend surgery to repair the damaged muscle.
Gluteus medius tendon repair can be accomplished by both minimally invasive open and endoscopic surgery. Both techniques have been shown to provide favorable patient outcomes in the hands of expert clinicians who treat this injury regularly. The choice of procedure is determined by the size and quality of tendon injury.
Regardless of technique, surgery to repair the torn tendon requires suturing the tendon back to the bone. This is accomplished with unique surgical techniques developed and published within the literature by Dr. Ajay Lall and his team. In some cases, an augmentation procedure is required to add biologic tissue to a degeneratively torn tendon, thereby enhancing its chances of healing.
In chronic cases where surgery has been delayed, or in revision settings where tendon quality is extremely poor and irreparable, our surgeons have developed unique techniques to transfer the neighboring muscle group in order to recreate what is missing. This procedure is called a gluteus maximus transfer procedure and is only done by very few clinicians worldwide.
Complete recovery time for gluteus medius repair surgery depends on the type of surgery performed by our surgeons and typically ranges from weeks to months. All patients treated at LALL Orthopedics+ will be provided a focused physical therapy regiment to be completed in multiple stages. The duration of protected weight bearing, and use of a hip brace varies as well from 2-6 weeks.
When you or a loved one is suffering with lateral hip pain or weakness, contact our expert team at LALL Orthopedics+ to schedule a consultation and receive the correct diagnosis for a uniquely complex problem that is treated in only select locations worldwide. Our team of clinicians have helped develop classification systems for Greater Trochanteric Pain Syndrome (GTPS), as well as an array of surgical techniques to repair these injuries. People from across the country seek out the care of Dr. Lall as a recognized and awarded expert in hip conditions and surgical solutions.
Dr. Ajay C. Lall is a former dual sport NCAA collegiate athlete (football and track & field), American board certified, triple fellowship-trained expert orthopedic surgeon who specializes in hip arthroscopy and robotic hip replacement. He treats non-athletes and athletes at all levels of play from collegiate to professional to the Olympic level. Dr. Lall is a world-renowned orthopedic surgeon who cares for all patients like family. Contact LALL Orthopedics + to schedule a consultation, receive the correct diagnosis, and undergo state-of-the-art treatment options.
At a Glance
Ajay C. Lall, MD, MS, FAAOS
- Board Certified – Orthopedic Surgery
- Triple Fellowship Trained
- Performs over 750 Surgeries Per Year
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