More advanced degenerative gluteus medius tendon changes do not respond as well. This protects the repair … Tears of the gluteus medius and minimus usually occur where the tendons insert at the greater trochanter, causing lateral hip pain. See Instructions for Authors for a … If a severe, full-thickness gluteus medius tear is present, surgical repair may be required. Sarah is a 27-year-old realtor who just recently joined a local recreational soccer league. It can occur from sudden bursts of activity and poor flexibility of the gluteus muscle. Unlike degenerative rotator cuff tears of the shoulder, both incomplete and complete acute tears of the gluteus medius respond well to repair surgery. Runners and athletes involved in high-impact sports may suffer from gluteus medius tendon tear. HIPABDUCTOR REPAIR PROTOCOL (Gluteus Medius/Minimus Repair) The following protocol should be used as a guideline for rehabilitation progression, but may need to be altered pending the nature and extent of the surgical procedure, healing restraints or patient tolerance. (Related Studies: Peritrochanteric Access and Gluteus Medius Repair and Gluteus Medius Repair With Double-Row Fixation) There are some circumstances where a large complete tear may be better managed with an open procedure to maximize the security of the repair. The function of the gluteus medius is to assist with pelvis stability, hip abduction, along with internal and external rotation of the hip. The tear or rupture of the gluteus medius muscle is commonly seen in runners and athletes involved in high-impact sports such as soccer or basketball. Initial treatment involves ice, non-steroidal anti-inflammatory drugs (NSAIDs) and activity modification to decrease pain and inflammation. Rehabilitation after a gluteus medius tear After surgery, you’ll need to use crutches and wear a hip brace during the initial stages of healing, and your activity will be restricted for 6 weeks so that the tendon can heal appropriately (like a rotator cuff). Sports Medicine & Orthopaedic Surgery ... repair, disregard the labral repair protocol and follow the gluteus medius protocol, as it is more restrictive. Finally, arthroscopic repair of the gluteus medius is now being done by more and more orthopedic surgeons. Again, many tears do not require surgery … Level of Evidence: Therapeutic Level IV. Arthroscopic gluteus medius tendon repair is a minimally invasive surgical procedure employed for the treatment of a gluteus medius tendon tear, when the tear does not respond to conservative treatment. Gluteus Medius Repair: In the event of a gluteus medius tear, arthroscopic repair may be possible. Gluteus medius tears may be mistaken for bursitis or a condition in your lower back. It can occur from sudden bursts of activity and poor flexibility of the gluteus muscle. “Endoscopic repair of the gluteus medius has shown to be effective in the 2-year term with good patient satisfaction, dramatic improvement in outcome scores … An associated tear of the gluteus minimus tendon was present at surgery in five patients, of which three were not seen on MRI (false negative). What is Gluteus Medius Repair? Be sure your surgeon, if you go this route, is experienced in hip arthroscopy in general, and gluteus repairs specifically. In some cases, long-term complications may develop. Gluteus medius tendon tears are typically seen in three scenarios: (1) chronic, nontraumatic tear of the anterior fibers of the gluteus medius tendon; (2) abductor tendon tears found in patients with femoral neck fractures or osteoarthritis; and (3) avulsion after total hip arthroplasty performed through an anterolateral or transgluteal approach. Gluteus medius repair surgery involves the following steps: You will be placed either under general anaesthesia or spinal anaesthesia The surgeon makes two or three small incisions, about 1/4 of an inch each, around the hip joint area. Gluteus medius tears cause pain and weakness on the affected side of the hip. Gluteus medius is one of 3 muscles in the buttocks and is situated on the outer surface of the hip. Contraction of this muscle allows us to lift our leg to the side (abduct). The tear or rupture of the gluteus medius muscle is commonly seen in runners and athletes involved in high-impact sports such as soccer or basketball. Worried about this pain, Sarah decided to go to her doctor to get her hip checked out. Postoperative recovery from a gluteus medius repair involves 6 weeks of restricted weight bearing with crutches or an assisted device and 6 weeks in a hip brace. My successful surgery for tendon repair (with a different orthopedic surgeon) was done 15 months after my THR. Any traumatic or overuse injury, or degenerative changes can also lead to partial or complete tear of the gluteus muscle. Over the past couple of weeks, Sarah has been suffering from pain in her right hip area, and this pain has progressively gotten worse with each practice and game. Modalities for pain control and swelling as appropriate Hip Abductor Tendon Repair Rehabilitation Protocol (Gluteus medius/minimus) The intent of this protocol is to provide guidelines for your patient’s therapy progression. The gluteus medius muscle helps hold the hip in place during walking. Gluteus Medius Repair (+/- Arthroscopic Labral Repair) The intent of this protocol is to provide guidelines for your patient’s therapy progression. If you experience symptoms of a gluteus medius tear that doesn’t get better after rest, icing, taking anti-inflammatory or pain medications, and modifying your activities, you should see Dr. Harris for a consultation. https://drjeffpadaleckimd.com/gluteus-medius-minimus-repairs-austin-texas It can be repaired arthroscopically when the tear does not respond to conservative treatment. We request that the PT/PTA/ATC should use appropriate clinical decision making skills when progressing a patient. A… The function of the gluteus medius is to assist with pelvis stability, hip abduction, along with internal and external rotation of the hip. Treatments for gluteus medius tear Patient will be released from the hospital the same day as surgery. – Seen 1x/week for 6 weeks to start at week 3 post surgery – Seen 2x/week for 6 weeks – Seen 2-3x/week for 6 weeks Precautions following Gluteus Medius Repair: – Weightbearing will be determined by procedure (protecting the repair) – Hip flexors tendinitis – Trochanteric bursitis – Synovitis While at the doctor's office, Sarah was put through several tests to see what was causing her pain. Weeks 1-4 • Bike for 20 minutes/day (can be 2x/day) • Scar massage • Gait training PWB with assistive device • Hip PROM o Hip flexion to 90 degrees, abduction as tolerated o No active abduction and IR o No passive ER or adduction (6 weeks) Open surgery has a longer recovery time, and patients will need more intense physical therapy to regain a complete range of motion. Gluteus medius is one of the major muscles of the hip and essential for the movement of the lower body. The steps involved in open surgery include: Surgery confirmed the presence of a tear of the lateral part of the gluteus medius tendon in all eight patients, with an associated tear of its main tendon in one patient, all tears revealed on MRI. Gluteus medius repair surgery involves the following steps: You will be placed either under general anaesthesia or spinal anaesthesia The surgeon makes two or three small incisions, about 1/4 of an inch each, around the hip joint area. Provide patient with home exercise program . ** If the patient had a microfracture, the patient will be non-WBing for the first 6 weeks (not ... gluteus medius tendon. One caveat, this is new technology. Gluteus medius is one of 3 muscles in the buttocks and is situated on the outer surface of the hip. Any traumatic or overuse injury, or degenerative changes can also lead to partial or complete tear of the gluteus muscle. 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