Overview
Tendinitis of the right gluteal tendon involves inflammation and potential rupture of the gluteus medius or minimus tendons, leading to pain, functional impairment, and gait abnormalities such as Trendelenburg gait. 1Diagnosis
Clinical Presentation: Pain in the lateral hip, difficulty with weight-bearing activities, and Trendelenburg gait.
Imaging: MRI or ultrasound to assess tendon integrity and detect tears or atrophy.
Grading: Utilize Lall's classification for gluteus medius tendon rupture, particularly Type 5 for massive ruptures. 1Management
Surgical Intervention: Whiteside transfer of gluteus maximus and tensor fascia lata muscles for massive ruptures (Type 5). Open or endoscopic approaches are viable options.
Functional Outcomes: Evaluate using modified Harris Hip Scores (mHHS), iHOT-12, Non-Arthritic Hip Score (NAHS), and Visual Analog Scale (VAS) for pain assessment.
Muscle Strength: Assess using MRC classification post-surgery.Special Populations
No Specific Data Provided: The abstracts do not cover management specifics for pregnancy, pediatrics, elderly, or comorbid conditions. 1Key Recommendations
Consider Whiteside Transfer for Massive Ruptures: For patients with Type 5 gluteus medius tendon rupture leading to treatment-resistant Trendelenburg gait, surgical intervention via Whiteside transfer can be effective. (Evidence: Moderate) 1
Comprehensive Functional Assessment Post-Surgery: Utilize multiple functional scoring systems (mHHS, iHOT-12, NAHS) and pain scales (VAS) to evaluate outcomes post-Whiteside transfer. (Evidence: Moderate) 1
Clinical Assessment of Muscle Strength: Incorporate MRC classification for assessing muscle strength recovery post-surgery to guide rehabilitation. (Evidence: Weak) 1References
1 Portet A, Lambrey PJ, Benhenneda R, Tanel L, Bauwens PH, Thaunat M. Short-term functional outcomes of Whiteside transfer for massive rupture of gluteus medius tendon in native hips. International orthopaedics 2024. link