The gluteus medius and gluteus minimus are two of the key muscle-tendon units that support the hip. These muscles originate in the buttock and attach to the greater trochanter, a bony prominence on the side of the thigh. Activation of the gluteal muscles allows one to lift his or her leg to the side (abduct) and extend the hip. Tendonitis or tears of the gluteus medius and/or gluteus minimus can occur after a traumatic injury or with long-term wear and tear.
In those patients who fail non-surgical management, Dr. Keller may recommend surgical intervention. During surgery, Dr. Keller maneuvers a camera and surgical instruments through small incisions adjacent to the peritrochanteric space (space on the outside of the thigh). Dr. Keller identifies the bursa (a fluid-filled sac) over the tendons and removes the bursa, which is usually inflamed. Dr. Keller then identifies the damaged tendon(s) with a camera and then prepares the area on the femur bone (greater trochanter) where the tendon(s) had torn. Next, Dr. Keller implants two or three suture anchors (medical screws with strong sutures) into the greater trochanter. Dr. Keller then passes the sutures connected to the anchors through the damaged tendon(s) and repairs the tendon(s) back down to the normal position on the femur bone with suture knots. The goals of surgery are to restore the normal function and strength of the gluteal tendons and to eliminate pain.
Following surgery, Dr. Keller recommends a guided physical therapy program with a licensed physical therapist. Early motion following surgery is very important, and Dr. Keller recommends that each patient either use a stationary bike or a continuous passive motion machine daily. Dr. Keller also recommends limited weight bearing and crutch use for 4-6 weeks after surgery. Dr. Keller may also recommend the use of a brace to help protect the hip.