Introduction

Abductor Tendinitis or hip abductor tendon tears are a well-recognized entity that results in progressive lateral hip pain, weakness, and limping. These can occur in patients with native hips or in patients following total hip arthroplasty. However, treatment of these 2 distinct groups does not differ.

Incavo, Stephen J;  Harper, Katharine D.JBJS Essential Surgical Techniques: April-June 2020 – Volume 10 – Issue 2

Abductor tendinitis
Abductor tendinitis

What are the causes?

Abductor Tendinitis is often caused by overuse while playing sports that requires a lot of jumping. It can also be caused if the nearby supporting muscles are to weak or to strong causing a muscle imbalance. Overuse can cause tiny micro-tears in the tendon. As the body tries to heal the tears, the tears develop faster that the body can fix them. As the number of tears increase they can cause pain from inflammations and weaken the tendon. In addition, age can contribute to wear and tear of tendons over time.

This condition is more prevalent in females above 40 years of age – Possible hormonal influence.

Other causes might also be:

  • If you run or walk with in-turning of the leg.
  • Alteration of intensity of physical activity.
  • Long distance running or walking.
  • Obesity

 

Whart are the symptoms?

Pain, stiffness and weakness in the hip are the most common symptoms. The pain is usually located near where the hip tendons insert on the proximal femur. The pain will often get worse when trying to walk or jump or with other activities. The pain tends to go away after the hip ” warms up”.

How is it diagnosed?

A physical exam must be performed where your health care provider may press on the are where the tendons attach to the hip to see if he can feel any hardness or swelling. He may also ask you to move your hip or leg to asses your range of motion. The Trendellenburg Test will indicate a weakness of the abductor tendons. If symptoms of hip tendonitis, tendinopathy, or abductor tears are found your healthcare provider may perform an X-ray, ultrasound or MRI scan to confirm the diagnosis

Classification

A new classification system that describe abductor tendon tear entities with more anatomic accuracy and to guide the appropriate surgical technique,

Type I: No evidence of gluteus medius avulsion from the bone
A: Partial tear of the gluteus minimus or gluteus medius tendon
B: Complete tear of the gluteus minimus tendon
C: Longitudinal tear of the gluteus medius tendon

Type II: Evidence of gluteus medius avulsion
A: Avulsion of <50% of the insertion into the greater trochanter
B: Avulsion of ≥50% of the insertion into the greater trochanter

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