Gluteus Medius and Minimus Tears Open Repair/Reconstruction

Abstract

The pathology of abductors’ tendons is the most common cause of greater trochanteric pain syndrome (GTPS). Half of the patients suffering from GTPS demonstrate gluteal tendinosis or ruptures. The rate of GTPS increases with age. The chief complaint of abductor tendon pathology is lateral thigh pain. A thorough clinical examination should be performed including the evaluation of muscle strength, neurologic status, lumbar spine, and hip pathology or the integrity of an existing prosthetic joint. Magnetic resonance imaging is the gold-standard examination of the pathology of the abductor muscles and tendons. The treatment of GTPS syndrome usually starts conservatively, including different modalities. Surgical management is mainly indicated for full or partial gluteal tendon ruptures that are nonresponsive to conservative treatment following at least 3 months of therapy, eliciting pain and disability to the patient. The patients that are scheduled to undergo surgical repair of gluteal tendon tears must have a thorough preoperative evaluation. Three are the main direct open methods, including open nonaugmented repair using bone tunnels or suture anchors or augmented repair with synthetic grafts or allografts and reconstruction for chronic end-stage abductor tears using muscle transfer.