Gluteus medius tendon tear

[Bet24]

I understand that this injury is comparable to a rotator cuff tear of the shoulder.  Am having great difficulty in receiving proper treatment.  Cannot have MRI because of previous aneurysm surgery. Ultrasounds show partial tear.  Pain in outer hip down outer portion of thigh, into kneecap, with sciatica-like pain for many years down back of leg.  I don't believe this can be cured with anti-inflammatory meds, but am being treated with a Flector patch at the moment.. If this doesn't help, doctor wants to try prolotherapy.  What are your thoughts on this procedure?  I understand arthroscopic surgery is now being done for these tears.  I have been disabled by this for many years, and hope to be able to find at least some partial relief from the pain and disability.  Please advise.  

[Michael L Gross, MD]

Prolotherapy uses a dextrose (sugar water) solution, which is injected into the ligament or tendon where it attaches to the bone. Theoretically, this causes a localized inflammation in these weak areas which then increases the blood supply and flow of nutrients and stimulates the tissue to repair itself.  The treatment is used for many different types of musculoskeletal pain, including arthritis, back pain, neck pain, fibromyalgia, sports injuries, unresolved whiplash injuries, carpal tunnel syndrome, chronic tendonitis, partially torn tendons, ligaments and cartilage, degenerated or herniated discs, TMJ and sciatica.  
Another possible injection therapy is the use of Platelet Rich Plasma (PRP) In PRP therapy, blood fromthe patient is cenrtifuged and concentrated platelets are then injected into the injury site. The PRP has been shown to contain high concentrations of various enzymes and growth factors known to stimulate soft tissue healing and tissue ingrowth.  This technology has been around since the 70's, but has become much more popular recently.
Finally, arthroscopic repair of the gluteus medius is now being done by more and more orthopedic surgeons.  You are correct in your analogy to the repair of the rotator cuff tendons.  One caveat, this is new technology.  Be sure your surgeon, if you go this route, is experienced in hip arthroscopy in general, and gluteus repairs specifically.

[belle2012]

A related discussion, Gluteus Medius Tear Recovery-Chiropractic was started.

[skye90]

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[skye90]

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[Bet24]

Thank you so much for your comments.  I had not heard of PRP previously.  I couldn't agree with you more in not having arthroscopic repair done by someone not specifically experienced in this type of surgery, and especially with repair of the gluteus tendon. I know of a doctor at HSS who has done work in this area, and I hope to be able to speak with him about taking me on as a patient.    As you state, to just find someone to go in w/o the experience is not the way to go.  I will look into PRP, but I've wasted so many years without resolution I feel the time has come to bite the bullet and try to resolve the problem once and for all.  Again, thanks for your response and encouragement.