2013 - Endoscopic Repair of Full-Thickness Gluteus Medius Tears

Abstract: Tears in the gluteus medius and minimus tendons recently have emerged as an important cause of chronic greater trochanteric pain syndrome. Increasing recognition of the gluteal insertion as a cause of chronic pain and weakness, as well as technologic advances in endoscopic hip surgery, has made gluteal insertional repair a rapidly emerging technique in minimally invasive surgery of the hip. We present an endoscopic double-row technique for gluteal insertional repair that allows for visualization, debridement, and repair, re-creating the normal footprint.

Tears in the gluteus medius and minimus tendons recently have emerged as an important cause of chronic greater trochanteric pain syndrome. Histori- cally, pain over the greater trochanter was presumed solely to be due to bursitis, but several studies have challenged this and shown gluteus tears as a source of pain. 1 Degenerative tears occur more often than acute tears, 2,3 and gluteus medius tears occur more often than gluteus minimus tears. 4,5

Tears at the insertion of the gluteus medius can be intrasubstance, partial, or complete and can occur either spontaneously or trau- matically. 4,6,7 Also referred to as the ” rotator cuff of the hip, ” these tendons pathologically share a number of similarities to those of the shoulder. In addition to repairing the tendon(s), the associated bursitis may also be treated. Although multiple publications exist regarding the treatment of bursitis, including open bursectomy and iliotibial band lengthening or release, few have addressed gluteal insertional pathologies