Clinical, radiological features, and surgical management of 6 patients with rupture of the gluteus medius tendon

ObjectivesThe rupture of the anterior part of the gluteus medius tendon has remained an ill-defined entity. The objectives are to develop some specific clinical signs, to emphasize the importance of MRI and to discuss the place of surgery.Patients and methodsSix patients were treated in the physical medicine department (Besançon) from 2009 to 2014 for trochanteric pain, with tears of the gluteus medius tendon confirmed by MRI. They all received suture surgery.ResultsIt was 4 women and 2 men (mean age 71 years). The interrogation at diagnosis: pain lasting for 5.4 months [3.5–9], no injuries reported, visual analog scale(VAS) 7.6 [5–9], sudden onset (83%), night pain (100%), Blazina score ≥ 3 (100%). Clinical examination: normal and symmetric range of motion except a limitation of 10 degrees of lateral rotation on the symptomatic side for 5/6 patients (83%), symptomatic triad (stretching, resisted contraction, palpation) in 100% of cases, positive Trendelenburg sign for 5 patients (83%) and 4/6 patients with decrease of the gluteus medius strength (cotation 4/5). All patients had an MRI: partial rupture (1 case), complete rupture (5 cases) of the anterior fibers of the gluteus medius. After failure of medical treatment, conducted on average 4.7 months [3–11 months], a surgical treatment was chosen for all patients. Clinical reassessment 6 months after surgery: significant improvement on pain: VAS=2.4 (0 to 5.5) (P