Abstract

Greater trochanteric pain syndrome (GTPS) is a common complaint. Recently, it has become well recognized that tendinopathy and tears of the gluteus medius (GM) are a cause of recalcitrant GTPS. Nevertheless, the clinical syndrome associated with GM tears is not fully characterized. We characterize the clinical history, findings on physical examination, imaging and intraoperative findings associated with symptomatic GM tears. Forty-five patients (47 hips) who underwent GM repair for the diagnosis of tear were evaluated. Pain was estimated on the visual analog scale (VAS) and hip-specific scores were administered to assess functional status. The imaging modalities were reviewed and intra operative findings were recorded. The average patient age was 54 years (17–76), 93% were females. Symptom onset was commonly insidious (75%) and the average time to diagnosis was 28 months (2–240). The most common pain location was the lateral hip (75%). The average pre-surgery VAS and modified Harris Hip Score were 6.65 (0–10) and 55.5 (12–90), respectively. All patients had pathological findings on magnetic resonance angiogram (MRA) ranging from tendinosis to complete tears of the GM tendon. There was a discrepancy between MRA interpretation by a radiologist and findings during surgery. Hip abductor tears are an under-recognized cause of hip pain and hip symptomatology. In this study, we further characterize the clinical presentation of this entity. The data we present here may facilitate early diagnosis, early orthopedic care and avoid unnecessary prolonged patient sufferings.

Highlights

  • Greater trochanteric pain syndrome (GTPS) is a common complaint with an estimated incidence of 1.8 per 1000 persons [1]

  • It has become well recognized that tendinopathy and tears of the gluteus medius (GM) and gluteus minimus tendons are a cause of recalcitrant GTPS [4,5,6,7,8,9,10,11]

  • GM tears are an under-recognized cause for hip pain and weakness

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Summary

Introduction

Greater trochanteric pain syndrome (GTPS) is a common complaint with an estimated incidence of 1.8 per 1000 persons [1]. It has become well recognized that tendinopathy and tears of the GM and gluteus minimus tendons are a cause of recalcitrant GTPS [4,5,6,7,8,9,10,11]. Their etiology remains unclear, but similar to rotator cuff tears in the shoulder, tears of the hip abductor tendons seem to occur through a degenerative and progressive process [12]. The true incidence of GM and minimus tears is unknown in the general and athletic population [13]

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