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gluteus medius strain or tear

Daniel J Kaplan, Andrew P Dold, David J Fralinger, Robert J Meislin
Patients with gluteus minimus and medius tears that fail nonoperative management may be indicated for surgical repair; however, structural failure after gluteal tendon repair remains unacceptably high. This is likely related to the limited healing potential of tendinous tissue, which is poorly vascular and heals by formation of fibrocartilaginous scar tissue rather than histologically normal tendon. An emerging option to augment tendon healing is the use of a bioinductive implant that is designed to amplify the host healing response and induce the formation of healthy tendon tissue...
August 2016: Arthroscopy Techniques
Jon A Jacobson, Corrie M Yablon, P Troy Henning, Irene S Kazmers, Andrew Urquhart, Brian Hallstrom, Asheesh Bedi, Aishwarya Parameswaran
OBJECTIVES: The purpose of this study was to compare ultrasound-guided percutaneous tendon fenestration to platelet-rich plasma (PRP) injection for treatment of greater trochanteric pain syndrome. METHODS: After Institutional Review Board approval was obtained, patients with symptoms of greater trochanteric pain syndrome and ultrasound findings of gluteal tendinosis or a partial tear (<50% depth) were blinded and treated with ultrasound-guided fenestration or autologous PRP injection of the abnormal tendon...
September 23, 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Sivan Navot, Leonid Kalichman
Pelvic floor muscle assessment in situations of hip/groin pain in both male and female patients can be a key element in treatment success. We present herein, a 32 year old male professional cyclist, exhibiting right hip and groin pain during cycling and prolonged sitting. The pain commenced after the patient suffered a right hip severe contusion in 2013 causing a tear in the tensor fascia lata and gluteus medius muscle. The patient did not complain of pelvic floor dysfunctions. After receiving several series of conventional physical therapy for the hip/groin pain, the patient experienced partial pain relief and slight improvement of hip range of motion...
July 2016: Journal of Bodywork and Movement Therapies
U Dorn, F Landauer, T Hofstaedter
Gluteal tendinopathy as well as partial and full-thickness tears of gluteal tendons (gluteus minimus and/or medius tendon) were underestimated as a cause of chronic pain in the past, and treatment was most commonly based on the diagnosis of trochanteric bursitis. Tendinous pathologies can either stay asymptomatic or cause pain and muscular dysfunction, not necessarily being associated with osteoarthritis of the hip 1. As the terminus "rotator cuff tear of the hip" was published in 1997 2, its aetiopathogenesis was reconsidered, resulting in improvements in diagnosis and treatment...
June 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Brian A Mosier, Noah J Quinlan, Scott D Martin
Over the last decade, there have been significant advances in endoscopic techniques for peritrochanteric disorders of the hip. Endoscopic repair of gluteus medius and minimus tears has demonstrated good to excellent results in most patients who meet surgical indications with extremely low complication rates. Treatment of coxa saltans and other peritrochanteric disorders are also described, though the literature lacks sufficient evidence to guide treatment. As our understanding of peritrochanteric disorders evolves, endoscopic intervention will continue to progress with the development of improved technology to treat these disorders and ensure good outcomes...
July 2016: Clinics in Sports Medicine
Christoph A Agten, Reto Sutter, Claudio Dora, Christian W A Pfirrmann
OBJECTIVES: To compare soft-tissue changes after total hip arthroplasty with posterior, direct-lateral, anterolateral, or anterior surgical approaches. METHODS: MRI of 120 patients after primary total hip arthroplasty (30 per approach) were included. Each MRI was assessed by two readers regarding identification of surgical access, fatty muscle atrophy (Goutallier classification), tendon quality (0 = normal, 1 = tendinopathy, 2 = partial tear, 3 = avulsion), and fluid collections...
June 24, 2016: European Radiology
Maureen K Dwyer, Cara L Lewis, Alfred W Hanmer, Joseph C McCarthy
PURPOSE: To determine if contact forces and electromyography (EMG) muscle amplitudes were altered during the lunge for patients with symptomatic labral tears compared with asymptomatic control subjects. METHODS: Surface electromyography electrodes were placed over the gluteus medius, gluteus maximus, adductor longus, and rectus femoris muscles of the patients' involved limb and matched limb of asymptomatic controls. Subjects performed 3 trials of the lunge on a clinical force platform...
April 27, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
N Harrasser, I Banke, H Gollwitzer, F Wilken, A Toepfer, R von Eisenhart-Rothe, M Hauschild
INTRODUCTION: Gluteal insufficiency is a common and challenging complaint. New concepts in pathobiomechanics and improved clinical understanding of chronic gluteal dysfunction have unmasked gluteus medius (GMed) tears as an underlying cause of enhanced trochanteric pain syndrome (GTPS). These tears are often missed or misdiagnosed as bursitis, but lead to prolonged chronic peritrochanteric pain. Clinic: The clinical signs are often dull pain on the lateral hip aspect, reduced hip abduction strength with positive Trendelenburg testing and a tendency for the leg to external rotation, as the internal rotation strength is reduced...
April 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
David M Levy, Ljiljana Bogunovic, Jeffrey S Grzybowski, Benjamin D Kuhns, Charles A Bush-Joseph, Shane J Nho
Abductor tendon tears typically develop insidiously in middle-aged women and can lead to debilitating lateral hip pain and a Trendelenburg limp. The gluteus medius tendon is most commonly torn and may show fatty degeneration over time, similar to the rotator cuff muscles of the shoulder. Endoscopic repair offers a therapeutic alternative to traditional open techniques. This article describes the workup, examination, and endoscopic repair of a full-thickness gluteus medius tear presenting as lateral hip pain and weakness...
February 2016: Arthroscopy Techniques
Dror Lindner, Noam Shohat, Itamar Botser, Gabriel Agar, Benjamin G Domb
Greater trochanteric pain syndrome (GTPS) is a common complaint. Recently, it has become well recognized that tendinopathy and tears of the gluteus medius (GM) are a cause of recalcitrant GTPS. Nevertheless, the clinical syndrome associated with GM tears is not fully characterized. We characterize the clinical history, findings on physical examination, imaging and intraoperative findings associated with symptomatic GM tears. Forty-five patients (47 hips) who underwent GM repair for the diagnosis of tear were evaluated...
October 2015: Journal of Hip Preservation Surgery
Frantz R Lerebours, Randy Cohn, Thomas Youm
Greater trochanteric pain syndrome (GTPS) is a term used to describe disorders of the peritrochanteric region. This constellation of conditions includes greater trochanteric bursitis, gluteus medius (GM) tears, and external coxa saltans or snapping hip syndrome. Tears of the abductor mechanism, more specifically gluteus medius tears, have recently gained a considerable amount of interest in the orthopaedic literature. Abductor tears were first described by Bunker and Kagan in the late 1990s. They used the rotator cuff as an analogous structure to describe the pathological process associated with gluteus medius tears...
March 2016: Bulletin of the Hospital for Joint Diseases
Sivashankar Chandrasekaran, S Pavan Vemula, Chengcheng Gui, Carlos Suarez-Ahedo, Parth Lodhia, Benjamin G Domb
BACKGROUND: Gluteus medius tears are a common cause of lateral hip pain. Operative intervention is usually prescribed for patients with pain despite physical therapy and/or peritrochanteric injections. PURPOSE: To identify clinical features that predict operative intervention in gluteus medius tears. STUDY DESIGN: Case control study; Level of evidence, 3. METHODS: A matched-pair controlled study was conducted on patients who underwent endoscopic gluteus medius repairs from June 2008 to August 2014 for full-thickness tears...
February 2015: Orthopaedic Journal of Sports Medicine
John W Thomas Byrd
Arthroscopic techniques for the hip joint have evolved into endoscopic methods for extra-articular disorders. These endoscopic strategies provide a less invasive alternative to open procedures for traditionally recognized forms of pathology. Endoscopy has defined new disorders amenable to surgical correction and has redefined some of these existing disorders. The peritrochanteric and deep gluteal regions represent 2 of the most currently active areas of exploration. Peritrochanteric problems include trochanteric bursitis, full-thickness and partial-thickness tears of the abductors including the gluteus medius and minimus, and external coxa saltans (snapping iliotibial band)...
December 2015: Sports Medicine and Arthroscopy Review
Geraldine Walsh, Colin G Archibald
The greater trochanter pain syndrome refers to pain on the lateral aspect of the hip joint. This is frequently attributed to trochanteric bursitis and distension of the subgluteal bursae. Associated tears of the tendons of gluteus medius and minimus have been described and may result from repetitive frictional trauma to these tendons and their associated bursae secondary to impingement beneath the tensor fascia lata. Occasionally tendinous damage may result from acute local direct trauma or a hyperadductive strain injury...
March 2003: Australasian Radiology
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