Rotator Cuff Tears of the Hip

Kagan, Abbott

doi:10.1097/00003086-199911000-00016

Cited by 188 publications

(136 citation statements)

References 3 publications

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“…1,2 More frequent diagnosis can be attributed in part to the increased use of magnetic resonance imaging (MRI), as well as an increased awareness within the orthopaedic community. Tears of the gluteus medius and minimus were first described in the 1990s as "rotator cuff tears of the hip" 3,4 and follow the same patterns of retraction, fatty atrophy, and occasional calcification as seen in the shoulder.…”

mentioning

confidence: 99%

All-Endoscopic Single-Row Repair of Full-Thickness Gluteus Medius Tears

Levy

Bogunovic

Grzybowski

et al. 2016

Arthroscopy Techniques

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Abductor tendon tears typically develop insidiously in middle-aged women and can lead to debilitating lateral hip pain and a Trendelenburg limp. The gluteus medius tendon is most commonly torn and may show fatty degeneration over time, similar to the rotator cuff muscles of the shoulder. Endoscopic repair offers a therapeutic alternative to traditional open techniques. This article describes the workup, examination, and endoscopic repair of a full-thickness gluteus medius tear presenting as lateral hip pain and weakness. The surgical repair for this case used a single-row suture anchor technique. In addition, the indications and technique for a double-row repair will be discussed.

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mentioning

confidence: 99%

All-Endoscopic Single-Row Repair of Full-Thickness Gluteus Medius Tears

Levy

Bogunovic

Grzybowski

et al. 2016

Arthroscopy Techniques

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show abstract

“…First, older patients may present with lateral hip pain and abduction weakness without a history of arthritis [16,17]. In these patients, chronic, degenerative abductor tears should be considered -particularly in those who have failed conservative therapy [16,17].…”

Section: Differential Diagnosismentioning

confidence: 99%

“…Narrowing the diagnosis, the examiner will notice point tenderness in the posterolateral area of the greater trochanter as well as pain with resisted hip abduction [5,12,13,17]. The examiner can also expect gait disturbances such as antalgic gait with or without Trendelenburg gait [5,7,12,13].…”

Section: History and Physicalmentioning

confidence: 99%

“…Early surgical repair should be considered before the onset of fatty muscular atrophy [16]. Open surgical repair has been the classic technique for treating abductor tendon tears since Kagan et al [4,17] published the first case series of open repairs for GTPS in 1999.…”

Section: Treatmentmentioning

confidence: 99%

“…Both arthroscopic and open repairs of the abductors have been shown to be effective treatments if conservative measures fail [1][2][3][4]. a traumatic event and in such cases history of such an event is helpful in categorizing the tear in this first group [16,17]. These degenerative and symptomatic tears will be the focus of our discussion.…”

Section: Introductionmentioning

confidence: 99%

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Hip Abductor Tendinopathy: Work-Up and Open Versus Arthroscopic Repair of Hip Abductor

Casscells¹

2016

OROAJ

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Prospective evaluation of magnetic resonance imaging and physical examination findings in patients with greater trochanteric pain syndrome

Bird

Oakley

Shnier

et al. 2001

Arthritis & Rheumatism

354

244

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Objective This study examined patients with greater trochanteric pain syndrome (GTPS) to determine the prevalence of gluteus medius pathology by utilizing magnetic resonance imaging (MRI), and to evaluate the presence of Trendelenburg's sign, pain on resisted hip abduction, and pain on resisted hip internal rotation as predictors of a gluteus medius tear in this group of patients. Methods Twenty‐four subjects with clinical features consistent with GTPS were recruited. A standard physical assessment was performed at study entry, including assessment of the 3 specific physical signs. Following this initial assessment, MRI of the affected hip was performed. A 1.5T whole body MRI system was utilized, with T1 and T2 fast spin‐echo sequences performed in the coronal and axial planes. All MR images were reviewed in random order by a single radiologist. In 12 patients, the 3 physical signs were assessed at study entry and at 2 months by the same observer and the intraobserver reliability for each of the signs was calculated. Results All subjects were women (median age 58 years, range 36–75 years). The median duration of symptoms was 12 months (range 12–60 months). MRI findings were as follows: 11 patients (45.8%) had a gluteus medius tear, 15 patients (62.5%) had gluteus medius tendinitis (pure tendinitis in 9 patients and tendinitis with a tear in 6 patients), 2 patients had trochanteric bursal distension, and 1 patient had avascular necrosis of the femoral head. Trendelenburg's sign was the most accurate of the 3 physical signs in predicting a tendon tear, with a sensitivity of 72.7% and a specificity of 76.9%. Moreover, Trendelenburg's sign was the most reliable measure, with a calculated intraobserver kappa of 0.676 (95% confidence interval 0.270–1.08). Conclusion The results support the hypothesis that gluteus medius tendon pathology is important in defining GTPS. In this series, trochanteric bursal distension was uncommon and did not occur in the absence of gluteus medius pathology. The physical findings suggest that Trendelenburg's sign is the most sensitive and specific physical sign for the detection of gluteus medius tears, with an acceptable intraobserver reliability. Further delineation with MRI, especially in patients with a positive Trendelenburg's sign, is recommended prior to any consideration of surgery in this group of patients. Finally, with the pathology of this condition defined, the challenge will be to devise and assess, by randomized controlled trial, an appropriate treatment strategy for this group of patients.

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Rotator Cuff Tears of the Hip

Cited by 188 publications

References 3 publications

All-Endoscopic Single-Row Repair of Full-Thickness Gluteus Medius Tears

All-Endoscopic Single-Row Repair of Full-Thickness Gluteus Medius Tears

Hip Abductor Tendinopathy: Work-Up and Open Versus Arthroscopic Repair of Hip Abductor

Prospective evaluation of magnetic resonance imaging and physical examination findings in patients with greater trochanteric pain syndrome

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