Gluteus Medius Tears: Repair of a Partial-Thickness Gluteus Medius Tear With Anchors

Gluteus Medius Tears: Repair of a Partial-Thickness Gluteus Medius Tear With Anchors

This cadaveric surgical video demonstrates a repair of a partial-thickness gluteus medius tear with anchors. Here, we see a left hip with the side of the hip facing the screen. The surgeon has already made small incisions, called portals, and inserted plastic tubes, called cannulas, to pass surgical instruments, including an endoscopic camera, into the hip.

Here, we see inside the hip from the camera. The surgeon is pointing out torn fibers of the gluteus medius tendon. The surgeon begins by using a sharp instrument to tap small holes into the top of the femur, or thigh bone, to promote the ability of the tendon to heal back to the bone. Next, the surgeon will place a soft-body anchor that is already threaded with sutures through the gluteus medius tendon into the thigh bone.

The surgeon drills a small hole through the tendon into the bone, inserts the anchor, and taps it in place through 1 of the portals. The surgeon removes the anchor inserter and pulls on the sutures from the anchor to make sure that the anchor is securely in the bone. The same steps are repeated to drill another hole and insert another anchor through the other portal. Next, the surgeon uses an instrument to grab the blue suture from each anchor and pull the suture out of the opposite portal to crisscross the sutures.

The surgeon applies tension to all of the sutures to get rid of any slack, then threads the blue suture from 1 anchor through the black and white looped suture from the other anchor. The end of the black and white suture is pulled to pass the blue suture into the anchor. The same steps are repeated for the other sutures and anchor. This will create a suture bridge across the 2 anchors. The surgeon pulls the blue sutures to compress the gluteus medius tendon down to the bone.

The surgeon uses a tensioning instrument to tighten each suture further and cut off the free end. Here, you can see the completed suture bridge across the gluteus medius tendon. The surgeon will close the skin incisions with sutures, and the surgery is complete.