Has anyone had gluteus medius/minimus tendon repair with good outcome?

Posted by skohl @skohl, May 11 12:47am

I have a high grade tear of gluteus minimus and smaller tear of gluteus medius. I am considering surgery but have seen some very discouraging posts for issues after surgery. I've tried PT, ice, modified physical exercise. Still aches while sleeping at night even when sleeping on "good" side with a pillow between my legs. I'm concerned surgery could have a worse outcome. If you have had a good outcome please describe your experience. Thanks in advance.

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Profile picture for kquilts @kquilts

I recovered 100% from a gluteus medius that was 80% detached from the bone. Surgery was successful and PT got me back to full use. No more aching at all.

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@kquilts I've had 7 hip surgeries, an artificial hip in 1984 and have not had a trochanter since my early 40's. In 2021 I had a fall and had to have the femur prostheses removed and rebuilt. At that time, my Surgeon reattached my glute medius to facia. I had to stay on a walker for 6 weeks while it healed. I have much more stability now and am very happy.

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Profile picture for preschoolnut @preschoolnut

@kquilts I've had 7 hip surgeries, an artificial hip in 1984 and have not had a trochanter since my early 40's. In 2021 I had a fall and had to have the femur prostheses removed and rebuilt. At that time, my Surgeon reattached my glute medius to facia. I had to stay on a walker for 6 weeks while it healed. I have much more stability now and am very happy.

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@preschoolnut so happy for your full recovery.

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I have low to moderate grade insertional tear of the posterior gluteus minimus and anterior gluteus medius tendon. MRI taken in May. I have had injections of cortisone which only helped for two weeks and short term PT. I'm fine when I wake up in the morning but after sitting I can hardly get up and walk as the pain is so bad. I am a female and will be 85 next month. I used to walk at least a couple of miles a day now am lucky if I can walk to the mailbox down the street. It's affecting me mentally as I need to get out and walk. My husband still runs a real estate company and our taking long walks was a good way for us to connect now I'm stuck at home. I haven't talked to a surgeon yet only the PA's but am afraid of surgery at my age.

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Profile picture for tamigl @tamigl

@kquilts Did your doctor detach the other 20% and reattach the entire gluteus medius or did s/he just reattach the detached 80% portion? The reason I am asking is because I'm at 50% and have a doctor who wants to detach it all before reattaching. Thanks for your response.

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@tamigl I don't know where you live. I'm in Northeast Ohio and saw doctors in Pittsburgh and all over Ohio, including the Cleveland Clinic. Doctors passed me around like a hot potato and I finally ended up at HSS in New York City- The hospital for special surgery.. honestly I wouldn't go anywhere else unless maybe Steadman in Colorado. I saw Dr. Anil Ranawat . I don't know how old you are. He takes Medicare. There was another doctor that I liked who did not take Medicare his first name was benedict.
My glute med is off the bone completely retracted and fatty atrophy. He said it's dead & nothing can bring it back. I need a procedure called a Glute Max transfer done inpatient @ NYC.
Then six weeks in patient rehab bc I live too far away to go home and I have no one to help me- no family etc.
Honestly, I wouldn't go anywhere else. I had been scheduled for surgery with another doctor in Ohio.
The first words out of his mouth were"It's a good thing you didn't have surgery with
-¥¥¥-- he's a bad doctor and got fired from £###!"
Just sayin' 🙏

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I had an injury in 2017 and had many broken bones fixed, but they didn't look at my hip. Since then, I think I've seen 12 ortho Drs I was misdiagnosed by all of them except the last 3... none of them were capable of doing surgery to help. One doctor said he could, but then my surgery was canceled and that surgeon quit. So I got on this message Board and found HSS.- the hospital for special surgery in New York City. They also have a beautiful facility in Paramus New Jersey.. I live in Cleveland, Ohio
And it's the only place I would go, knowing what I know. I've met with a brilliant surgeon there- who is one of the leading experts of Glute surgeries in the country maybe the world. HSS is the the top orthopedic hospital in the country some say the world- they specialize in orthopedics
I met some other wonderful people in this cohort- they have gone to HSS.
The recovery is very tough, but not having the surgery is worse. Lets talk Pain. - the pain is unforgiving, but the surgery will fix that.
Unfortunately, my muscle has been off the bone and retracted for so long that the muscle is dead. Even with a Glute Max transfer done inpatient along with 6 wks inpatient rehab & a brace, plus outpatient rehab I'm still looking at using a cane the rest of my life and probably a specialty euro Walker that I use when I go outside.
It's very disappointing because I used to be a professional ski coach skate 4 to 5 days a week.
Please find a good Surgeon
That's the trick.
I'm having it done later this year with Dr Anil Ranawat. He's got some videos you can Google plus a website.
Good luck I literally feel your pain🙏

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Profile picture for gussie @gussie

I have low to moderate grade insertional tear of the posterior gluteus minimus and anterior gluteus medius tendon. MRI taken in May. I have had injections of cortisone which only helped for two weeks and short term PT. I'm fine when I wake up in the morning but after sitting I can hardly get up and walk as the pain is so bad. I am a female and will be 85 next month. I used to walk at least a couple of miles a day now am lucky if I can walk to the mailbox down the street. It's affecting me mentally as I need to get out and walk. My husband still runs a real estate company and our taking long walks was a good way for us to connect now I'm stuck at home. I haven't talked to a surgeon yet only the PA's but am afraid of surgery at my age.

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@gussie hello dear I'm sorry you experiencing this and I understand your concern about having surgery at your age. I'm 72 and I've had friends have shoulder and hip replacement in their mid 80s and done very well.
I had a Glute medius tear and was misdiagnosed as bursitis. It got so bad that it is completely off the bone and the muscle has died. I saw over 10 doctors and did two years of PT often on injections and it just got worse.
I live in Cleveland, Ohio and I've been to NYC and Paramus New Jersey to meet with Dr Anil Ranawat a top a preservation specialist at the HSS- hospital for special surgery.
Had a lot of questions about prior injections and treatment & said nothing but surgery would help my situation. I'm getting a Glute Max transfer and will always need a cane... and maybe my Walker because it's so bad
He did say it was a good thing that I did not have surgery with a particular Dr that I had scheduled last year when they suddenly left. He knew him and said he was a bad surgeon 😳.
It's interesting that a doctor in New York with no doctors in Oh & Pa. I think I saw 12 drs before ending up at HSS.
You could always go for a second opinion they can't hurt, but they may want you to have the MRI done in their system. I would schedule at Paramus New Jersey.
Best of luck I used to hike in Ski all the time I know how important this walks are for yourself and for time with your husband🙏

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Profile picture for weevilone @weevilone

Just a quick update from me. I had a gluteus medius tear repaired on 8/24 so I’m 2 weeks out. They also cleaned out a lot of calcification, so some additional damage was induced debriding this.

Things have been going well. I got the brace unlocked to 90 degrees on 9/2 but the swelling in the hip (and associated knee) has been too much to sit anyways. I started physical therapy last Friday, so I’m doing exercises every couple hours. Since my tear was less severe than the imaging looked, I am cleared for 25-50% weight bearing now and expect to be cleared for 100% on 9/16. I will still wear the brace and will have my movements restricted for the full 6 weeks.

So certain aspects have been accelerated for me since it was a partial thickness tear, but I’ll still be restricted for the normal duration and I’ll follow the usual physical therapy path. The surgeon feels that part of my symptoms have been driven by the calcification. Unfortunately, this was my good hip prior to the acute tear, so I may need the left hip debrided and cleaned out as well down the road.

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@weevilone where did you have your surgery done and who is your Surgeon please? That information would be really helpful.

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Profile picture for ennaoj44 @ennaoj44

Thank you for your email. There are so many conflicting messages from orthopedic surgeons many who are not versed on gluteus medius or minimus tears. Like you, I am living your experience, am 82 yrs of age with good health and many years ahead of me. I experienced a gluteus medius tear following a hip replacement. but was treated for bursitis. It was a spine surgeon who ordered an MRI because he thought I had a gluteus tear. Bingo, a missed diagnosis for months. I've met w/ three orthopedic surgeons locally, all advised against a gluteus medius transfer. However, I had an appointment with Dr. Robert Barnett at Rush Orthopedic Center in Chicago. He has a reputation for successful gluteus medius transfers. Dr. B did say moving slowly, etc., thru months of recovery I would no longer have a Trendelenburg gate and balance would be improved, but would not speak to reduced pain. So, I'm on the fence and every time I lose my balance I give surgery another thought. I, too, walk w/ a cane outside the house, but furniture walk, use door frames, any thing I can reach out and grab when needed while walking in the house. PT was not beneficial to me, nor is an injection from pain management. I start my day with a heating pad under my hip, this gives me a good start--gets me moving. You might want to ask for a prescription pain med to help when pain is unbearable, not every day, but when unbearable. Over the counter meds just don't give relief. If you sleep on your back, you have some night time relief. I sleep nightly w/ half/split Trazodone 50 Mg Tablet. This helps a lot.
I wonder if AARP would consider writing up a detailed article on the topic of gluteus medius tears, because I have come across many who have our experience and have had no place to turn. Yes, the Internet has much info, but there are very few US orthopedic surgeons who perform a gluteus medius transfer surgery. And not one of the orthopedic surgeons locally with whom I met or are following me knew of or could refer me to a surgeon who performs transfers. I have done much research, made telephone calls, etc, so I feel informed. But slow to decide on surgery. Wishing you well. Stay in touch. Joanne

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@ennaoj44 hi i've been off for a while, but was looking for your info.
I'm 72 and injured nine years ago and completely misdiagnosed. So I've seen over 10 doctors maybe it's 12 and the bottom line is I went to New York twice this summer to the HSS hospital for special surgery and met with a top hip preservation. Surgeon takes Medicare and he was so frustrated when he saw my MRI and heard my history. He said my muscle is completely dead. It can't be fixed. It's been injured and misdiagnosed for too long.
He recommended a Glute Max transfer, a trochanter bursectomy, and anything else that he sees during surgery.
He said I don't need a hip replacement. My bones are fine. He said no amount of PT injections or shockwave therapy would help me at this point. now I will always walk with a cane and maybe a walker when outside. He said the pain will improve👍
I have a Specialty Drive, Nitro European style Walker. I took it to Asia last year and I was able to ride a train into New York City and get around using it. I have a folding cane & backpack . I'met a patient in a dr office who had the same walker and they told me they traveled to Africa with it ! so I ordered one from Walmart rather than especially adaptive aid supplier. It's the exact same thing and half the price. Although I have taken it in to a supplier to have the wheel adjusted. I use it every day. It's superior to standard walkers.
I saw Dr. Anil Ranawat @ HSS. This summer. They also have a massive facility in Paramus New Jersey with free parking and easy suburban traffic. The doctors go to both places for appointments and sometimes surgery depending on what you're getting. I live in Cleveland and when I was in Pittsburgh recently, met someone who'd gone to HSS for back surgeries after having surgery somewhere else.
I'll probably have surgery in December or March - working on my schedule since I'll be non-weight-bearing for at leastsix weeks
Best of luck, Pam

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Profile picture for weevilone @weevilone

This has given me something to do while laying flat on my back. I’m 5 days out from a repair for a full thickness tear of my right gluteus medius tendon. The pain hasn’t been difficult and I didn’t need any meds at home. So far the most difficult things have been using the toilet and showering, and my arthritic hands are already tired of the crutches and walker. I am also in my head a little, worrying about damaging the repair. My restrictions are no load bearing, a brace to limit hip movement to 60 degrees, and no abduction or adduction.

I’m 57 male and managed to tear this while doing PT for the left hip. I cannot imagine having the strength and stamina for recovery at a more advanced age.

I had the repair done by Dr. Devon Myers in St. Louis. He has been fantastic, but the hospital seemed vastly unprepared to care for me after. The nurses simply underestimated the difficulty and weren’t going to let me talk with occupational therapy. Heck, they were expecting me to walk to the car and I was weak and unsteady, having never used crutches. By then I was more than 24 hours out from any nutrition, having had nothing aside from ice chips and water. I guess my advice is to be sure both the surgeon and post-op care team are prepared. I think the procedure is uncommon enough that the nurses simply hadn’t experienced it,

Edit: In my case, the tear was found to be a little less severe than believed from MRI. I had significant calcification that had to be cleaned out. It made the tear more difficult to assess without going in. Dr. Myers also cleaned out the calcification, which is now believed to be responsible for my left hip pain that started this mess. I hope to get that taken care of also. I did not respond well to one year of PT.

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@weevilone postop care is a huge problem. I've talked to many people who said they've been injured because the nursing staff doesn't understand the surgery and postop care.😖.
I saw one Surgeon, who insisted the surgery could be done outpatient, but then the outpatient surgery center canceled it and said it had to be done as an inpatient.
I've had a second opinion at the HSS hospital in New York city and they said my surgery had to be done inpatient at the main hospital and then I could go home after a day or two. But I don't have anybody to take care of me at home so this they get a Social Worker to help me figure out how I can go to inpatient rehab. Plus, I live in Cleveland and the hospital was in New York City so it's not like somebody can just drive me home in an hour.
I really appreciate hearing your story. I hope you're doing better. I'm 72.
I heard there is a really good hospital in St. Louis for this type of surgery Beth Israel? I'm glad you like your doctor. Some other people have gone to a lady Surgeon from Argentina St. Louis.
Best of luck and thank you so much for your post. It's very informative.

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Profile picture for ennaoj44 @ennaoj44

@weevilone Thank you for sharing. So from what I read your surgery performed was to repair a full thickness tear which translated is a complete tear. More about the repair: how attached? Did you have a gluteus maximus/medius transfer? Because mending/repairing a gluteus tear is as my surgeon tells me "is like trying to sew hamburger together".
I do wish you the best in this long stretch of recovery time and be cautious in every move you make. Do you have a complete list of movements, etc., that you ought not to do or very carefully? Like bending, no heavy lifting, climbing stairs, getting up out of seating, and how/positions to sleep, etc.? If you have time you may want to Google gluteus repairs and oh my you will find answer to questions you haven't likely thought of. Joanne K

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@ennaoj44 I can't help but smile when you say it's like trying to sew hamburger together, it's like fatty atrophy there's no muscle to grab onto plus it's off out and can't return to muscle. A surgeon told me if there was such a thing as a reverse hip replacement that would be an option like a reverse shoulder replacement for shredded rotator cuff, etc. but he said it doesn't exist so the only thing they have is a Glute Max transfer... and not many doctors can do it successfully and most don't even try, thank goodness.
One sports medicine doctor told me " orthopedic doctors hate to treat lateral hip pain! When I asked why they said there's no good options and it's very difficult to treat!
My experience has been most doctors passed the Buck and & give patient hope that it'll get better with PT or something else.
Unfortunately, all that I've heard now- a tear usually requires surgery

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