Gluteus medius / minimus repair

Most gluteal tendon problems are managed first without surgery, and many people improve that way. Repair is generally considered when a tear is confirmed and meaningful pain or weakness continues despite a fair trial of nonsurgical care, or in selected situations where a repair is felt to give the best chance of restoring function.

The decision is individualized. It weighs your symptoms and function, the size and pattern of the tear, how far the tendon has pulled back, the quality of the muscle and tendon, other conditions in the hip, and your goals — a fuller discussion is on the gluteal tendon problems condition page.

In a gluteal tendon repair, the surgeon reattaches the torn edge of the gluteus medius and/or minimus tendon to its footprint on the greater trochanter, usually with small anchors placed in the bone and sutures that hold the tendon against the bone while it heals. Any degenerative or frayed tissue may be addressed, and the goal is a secure repair that restores the tendon's attachment.

The specifics — how the tendon is prepared and secured — depend on the tear and are decided by your surgeon. The point of the repair is to reestablish the attachment so the muscle can again do its job of moving and steadying the hip.

A gluteal tendon repair can be performed arthroscopically — through small incisions using a camera and instruments — or through a traditional open incision over the outer hip. Each approach has situations where it is well suited, and neither is universally better than the other. The choice depends on factors such as the size and location of the tear, the quality of the tissue, and what the surgeon finds and judges best for a durable repair.

What matters most is a secure repair and a rehabilitation that protects it. Your surgeon will discuss which approach is planned for your situation and why.

Sometimes other problems are addressed at the same time — for example inflamed bursal tissue, or a tightness that is contributing to symptoms — and occasionally the extent of the tear or the quality of the tissue seen during surgery differs from what imaging suggested. Findings like these, or procedures done together with the repair, can change how the repair is protected afterward.

For that reason, your specific rehabilitation is set by your surgeon based on what was actually done. The rehabilitation protocol linked below describes the general path; your operative note and your surgeon's instructions take precedence.

Recovery after a gluteal tendon repair is gradual and staged. Early on, the repair is protected — this commonly includes a period of limited weight bearing on the leg, limits on certain hip movements, and sometimes a brace, as your surgeon directs — to give the tendon time to heal to the bone. From there, motion is gradually restored, then the hip and pelvic muscles are progressively strengthened, and finally activity is advanced toward your goals.

The pace is guided by healing and by how your strength and control return, not by a fixed calendar. The gluteus medius/minimus repair rehabilitation protocol below lays out the general progression; the specific restrictions and timing are set for you by your care team.

Every operation has trade-offs. The possibilities below are for discussion with your surgeon and are not a complete list:

• Infection
• The tendon failing to heal fully, or re-tearing
• Persistent pain or weakness in the hip
• Stiffness
• Numbness near the incision
• Blood clots
• Nerve or blood-vessel injury (uncommon)
• A need for further treatment or surgery

The goal of a gluteal tendon repair is a healed tendon and a hip that is stronger and more comfortable for your daily life and activities. Recovery is gradual and protected, and results are individual. The right path — and whether repair is part of it — is the one matched to your specific tear and situation after a clear conversation with your surgeon.