When conservative treatment fails


Treatment options:

Nonoperative management

  •      Physical therapy
  •      Nonsteroidal anti-inflammatory drugs
  •      Activity modification with assistive walking devices.

Surgical alternatives

  •      Endoscopic or open direct soft-tissue repair
  •      Suture anchor repair
  •      Bone tunnel repair
  •      Graft jacket reconstruction
  •      Gluteus maximus muscle transfer.

Indications for surgery

Absolute indications
Magnetic resonance imaging (MRI) evidence of gluteus medius and/or complete abductor complex avulsion

Relative indications
Pain and disability for >6 months despite conservative therapy (including nonsteroidal anti-inflammatory drugs [NSAIDs] and physical therapy)
MRI evidence of gluteus medius or gluteus minimus tendinitis and/or a partial tear.

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