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Endoscopic Gluteus Medius Repair: Case Presentation and Surgical Technique

March 15, 2015

Contributors: Jason Capo, MD; Maxwell Weinberg, MD; Dylan Lowe, MD; William Ryan, BS; David Choueka, ; Thomas Youm, MD, FAAOS; Thomas Youm, MD, FAAOS

BACKGROUND: Gluteus medius tears are an uncommon but increasingly recognized condition, most often seen in middle-aged women. In the past, lateral sided hip pain was traditionally considered trochanteric bursitis. However, lateral sided hip pain recalcitrant to nonoperative treatment can result in an MRI of the hip which would diagnose a gluteus medius tear. Full thickness gluteus medius tears and certain partial thickness tears do not always respond to nonoperative treatment. When indicated, endoscopic repair can be performed to completely reestablish the function of gluteus medius tendon. The purpose of this video is to show the operative technique of an endoscopic gluteus medius tendon repair. Arthroscopic techniques that have been previously described usually involve traditional knot tying techniques from suture anchors. This video demonstrates a knotless tendon repair technique which would eliminate any irritation from prominent suture to the iliotibial band and bursa.

METHOD: This video presents a technique to surgically repair gluteus medius tears endoscopically. Relevant patient history, workup, nonoperative management, indications for surgery, pre and postoperative imaging, and postoperative rehabilitation are presented. Repair of the tendon was performed with fiber tape, and the tendon was reinserted into the greater trochanter. The important features of the technique are highlighted including patient setup, approaches, and repair method.

RESULTS: In this video, we successfully demonstrate the endoscopic repair of a gluteus medius tendon. The tendon was properly restored to its anatomic position with excellent security. Clinical outcomes in the orthopaedic literature report favorable short term results with full restoration of range of motion.

CONCLUSION: Growing clinical awareness, improvements in imaging, and advanced hip arthroscopic techniques have made endoscopic repair of torn gluteus medius tendons a reasonable option for failed treatment of these tears. Short-term results for endoscopic repair have been found to be promising with minimal complications. This video demonstrates the techniques to provide a reliable and successful method of repair.

Results for "Hip Preservation"

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