Abstract
Tears in the gluteus medius and minimus tendons, often misdiagnosed as trochanteric
bursitis, have recently emerged as an important cause of recalcitrant greater trochanter
pain syndrome. Advances in endoscopic surgery of the hip have created opportunities
to better evaluate and treat pathology in the peritrochanteric compartment. We reviewed
the literature on trochanteric pain syndrome and gluteus medius tendon injuries. Existing
techniques for endoscopic and open gluteus tendon repair and potential challenges
in restoration of abductor function were analyzed. Partial-thickness undersurface
tears of the gluteus medius were identified as a common pathologic entity. Although
these tears are otherwise analogous to partial-thickness tears of the rotator cuff,
the lack of arthroscopic access to the deep side of the gluteus medius tendon represents
a unique technical challenge. To address the difficulty in visualizing and thus repairing
undersurface tears of the gluteus medius, a novel endoscopic trans-tendinous repair
technique was developed. The purposes of this article are to review the anatomy, pathology,
and existing repair techniques of gluteus medius tendon tears and to describe the
rationale and surgical steps for endoscopic trans-tendinous repair.
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Article info
Publication history
Published online: October 18, 2010
Accepted:
June 1,
2010
Received:
May 3,
2010
Footnotes
B.G.D. has received from Arthrex, Naples, Florida, support exceeding US $500 related to this research. The other authors report no conflict of interest.
Note: To access the videos accompanying this report, visit the December issue of Arthroscopy at www.arthroscopyjournal.org.
Identification
Copyright
© 2010 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
