Greater Trochanteric Pain Syndrome, Abductor (Gluteus Medius & Minimus) Tears
Trochanteric bursitis is a common problem characterized by tenderness over the outside edge of the hip area. It is often associated with pain when trying to lie on the side. Bursitis will typically respond successfully to non-surgical treatment including therapy, anti-inflammatory medication and, occasionally, a well-placed cortisone injection.
However, many cases of what seems like bursitis may not be bursitis at all. When the symptoms do not respond as would be expected, a deeper investigation may be prudent. Acute injury or deterioration and spontaneous rupture of the tendons along the outside border of the hip can occur. These structures make up the abductor muscle group and include the gluteus medius and the gluteus minimus. These types of problems usually start to occur in patients over the age of 45. MRI tends to be very useful in assessing abductor injuries. Strains and partial tears may respond to conservative measures, but often require more intensive treatment than simple bursitis. A trial of conservative treatment is always appropriate but, when non-surgical methods fail, some severe partial thickness and complete ruptures may require arthroscopic surgical repair. In these circumstances, the symptoms are usually more severe, including a pronounced limp and significant restrictions in the patient’s abilities to participate in many normal daily activities. The recovery is prolonged, with crutches for six to eight weeks and precautions for four months, but the surgery can be quite beneficial. |
