Cartilage Injuries: Small Cartilage Defect Treatment Animation

Cartilage Injuries: Small Cartilage Defect Treatment Animation

The glutes are a group of muscles located around the hips. They include the gluteus maximus, gluteus minimus, and gluteus medius. The gluteus medius is the main muscle located at the sides of the hips that moves the leg out to the side and stabilizes the pelvis when balancing and transferring weight from 1 leg to the other. Pain at the sides of the hips can be classified under the umbrella term of greater trochanteric pain syndrome, or G T P S.

This condition often develops from irritation to the gluteus medius tendon. This tendon attaches to the greater trochanter, the bony bump at the top of the femur, or thigh bone. This tendon can become irritated over time, resulting in tendinopathy or tendinitis, or can tear away from the bone. Gluteus medius tendon tears often occur gradually over time and rarely occur from trauma. Because of this, partial tears, where only some of the tendon’s fibers tear off from the bone, are the most common.

Gluteus medius tendon tears affect both males and females but are more common to occur in women between the ages of 40 and 60 without a prior injury. Occasionally, a gluteus medius tendon tear can occur over time after a total hip replacement if the gluteus medius muscle was cut through during the surgery. Symptoms of a gluteus medius tendon tear include pain at the outer side of the hip, tenderness over the greater trochanter, and pain and weakness with moving the leg out to the side.

Patients will often report that pain gets worse with walking, running, prolonged sitting, and sleeping on the affected side. To diagnose a gluteus medius tendon tear, a health care provider will examine the hip and see if the outer side of the hip is tender to the touch. They will also check a patient’s hip range of motion and strength, will examine how the patient is walking to see if there is a limp, and may ask the patient to stand on 1 leg.

Normally when standing on 1 leg, the pelvis will be level because the gluteus medius is working to stabilize the hip. When there is a tendon tear, the muscle cannot properly stabilize the pelvis, which will drop down to the opposite side when standing on 1 leg. This is called a Trendelenburg sign. To help confirm a diagnosis of a gluteus medius tendon tear, a health care provider may order an MRI to see if there is damage to the tendon. Sometimes, x-rays may be used to see if there are any other hip conditions, such as osteoarthritis or malalignment of the bones, but they cannot be used to determine if a tear is present.