Open Gluteus Medius Repair
What is Open Gluteus Medius Repair?
The gluteus medius is a muscle located on the outer part of the pelvis. It plays an important role in moving the leg sideways, away from the body. Tears in the gluteus medius can be a source of significant pain and dysfunction. Open gluteus medius repair is an open surgical procedure performed to treat gluteus medius tears.
What are the Signs and Symptoms of a Gluteus Medius Tear?
Some of the signs and symptoms of a gluteus medius tear include the following:
- Decreased strength on resisted abduction
- Presence of a gait change
- Lateral hip pain
- Greater trochanter tenderness
- Hip weakness
Diagnostic Tests for a Gluteus Medius Tear
The commonly used test for diagnosing a gluteus medius tear is an MRI. Tears are classified into partial-thickness tear, full-thickness tear, or tendinosis. If the MRI is uncertain, then peritrochanteric local anesthetic injections may be helpful in confirming the diagnosis.
What are the Treatments for a Gluteus Medius Tear?
Treatment for a gluteus medius tear includes both non-surgical as well as surgical options.
- Non-Surgical Options: Nonoperative management is the favored treatment for chronic abductor tears. Treatment usually includes physical therapy, judicious use of steroids and anesthetics, and use of nonsteroidal anti-inflammatory medications.
- Surgical Options: Operative management is usually employed on patients with persistent pain and functional limitation despite nonoperative management. Surgery may be performed using either a traditional open surgery or endoscopically through tiny incisions with an endoscope.
What are the Indications for Open Gluteus Medius Repair Surgery?
Operative intervention is suggested to treat this condition if tears do not respond to conservative treatments including peritrochanteric injections and/or physical therapy. Small hip abductor tears may be amenable to arthroscopic treatment, whereas large or chronic tears are best treated with an open gluteus medius repair approach.
Surgical Procedure of Open Gluteus Medius Repair
During this procedure, the patient will be brought into the operating room and placed under general anesthesia in a supine position. As part of an open abductor repair, an incision will be directly made over the gluteus medius tear, the bursa will be detached, and the damaged muscle tendons will be identified. Suture anchors will be placed in the greater trochanter and sutures will be passed through the torn muscle tendons to rejoin tissues separated by trauma or degenerative process to their anatomic location on the femur.
Postoperative Care for Open Gluteus Medius Repair
Post-surgery, you will normally have to stay 1 to 2 days or longer in the hospital depending on your condition. Physical therapy rehabilitation will start one day after surgery. As part of the post-operative rehabilitation, limited weight bearing and strengthening exercises will be employed. The first outpatient physical therapy appointment is usually made 3 weeks post surgery. Rehabilitation guidance will be patient specific depending on the patient’s health status, age, rehab compliance, and the procedure performed. All exercises must be performed within pain tolerance as increased discomfort may affect the healing process.