The gluteus medius and gluteus minimus are muscles which are important for motion and stability of the hip joint. They are key to activities of daily living as well as sporting activities. The muscles originate on the pelvis and insert on the femur, at the greater trochanter. The greater trochanter is an area near the top portion of the femur (thighbone). In some instances the tendinous attachment of these muscles can undergo degeneration and/or detachment at their insertion site on the greater trochanter. This injury to the tendon can result in hip weakness, pain, and/or disability. Surgeons have recently begun utilizing arthroscopic surgery techniques for repair of these tendons where they insert on the greater trochanter.
In patients with hip pain and weakness, Dr. Anz will first evaluate for signs of tendon injury. If the gluteus muscles are found to be injured, some can improve with rest and therapy to strengthen muscles around the hip. Anti-inflammatory medication and stretching can also help decrease symptoms for some patients. If pain and functional limitations persist, surgery to repair the tendon at the attachment site may be helpful. The arthroscopic repair of the gluteus medius and/or minimus tendons is usually accompanied with removal of surrounding tissue that has become irritated, including inflammed greater trochanter bursal tissue. Additionally, a tight band of tissue overlying the area, the iliotibial band, may also be released. In some instances, can help decrease pain associated with inflammed bursal tissue, also know as bursitis.
During surgery, the torn gluteus medius or minimus tendon will be reattached to the native attachment site near the top of the femur on the greater trochanter. Suture anchors are embedded in the bone and strands of suture are then passed through the pulled-off portion of the tendon using specialized passing instruments. By tying these sutures, the torn tendon is once again attached to the bone.
Following arthroscopic hip surgery for a gluteus medius repair or gluteus minimus repair, patients will need to avoid certain hip motions and exercises for 6 weeks. A brace helps to decrease stress at the repair site during this time as well.
For more information on arthroscopic hip surgery or for additional resources on the repair of a gluteus medius or minimus tear, please contact the Gulf Breeze, Florida orthopedic surgeon, Dr. Adam Anz located at the Andrews Institute.