Gluteus Medius Tear & Endoscopic Repair in Frisco, TX

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The gluteus medius and minimus tendons attach to the bony point on the outside of the hip. They are sometimes called the “rotator cuff of the hip.” They keep the pelvis level when you walk. When these tendons wear or tear, the result is persistent outer-hip pain that is often diagnosed as “bursitis” and treated for months without lasting relief.

At a glance

Pain on the outside of the hip, worse lying on that side or climbing stairs
A limp, or the hip “giving out,” suggests weakness from a tear
Most common in middle-aged and older adults, especially women
MRI confirms the diagnosis
Persistent tears can be repaired endoscopically through small incisions

Bursitis or a gluteus medius tear?

Both cause tenderness over the outer hip. The key differences:

	Bursitis / tendinopathy	Gluteus medius tear
Pain	Outer hip, worse lying on the side	The same, often more persistent
Weakness or limp	Usually absent	Common (a “Trendelenburg” limp)
Response to injection	Often good	Often short-lived
MRI	Inflammation, tendon thickening	Partial or full-thickness tendon tear

If “bursitis” keeps coming back after injections, or you’ve developed a limp, ask about an MRI to look for a tear.

How common is outer hip pain?

Very common, especially in women. In a study of more than 3,000 adults aged 50 to 79, nearly 1 in 4 women (23.5%) and about 1 in 12 men (8.5%) had greater trochanteric pain syndrome, the umbrella term for outer hip pain coming from the gluteal tendons and bursa.¹ Many of these patients have tendinopathy (tendon irritation and wear) rather than a full tear, and that difference shapes treatment.

Symptoms

Aching on the outside of the hip that may spread down the outer thigh
Pain lying on the affected side at night
Pain with stairs, standing on one leg, or getting up from a chair
A limp or a feeling of weakness

Non-surgical treatment

Physical therapy targeted at gradual tendon loading and hip strength
Avoiding positions that compress the tendon, such as crossing the legs or lying on the painful side
Anti-inflammatory medicine
Injections. Cortisone can calm pain, but repeated steroid injections may weaken tendons. Some patients consider PRP, which has some supporting evidence for gluteal tendinopathy but is not FDA-approved specifically for this use.

What the research shows

Exercise first. In a randomized trial of 204 people with gluteal tendinopathy, an 8-week program of education plus targeted exercise worked better than a cortisone injection. At 8 weeks, 77% of the exercise group reported success, compared with 58% after a cortisone injection and 29% with a wait-and-see approach. At one year, 78% of the exercise group reported success, compared with 57% after the injection.²
PRP compared with cortisone. In a randomized, double-blind trial of 80 patients with long-standing gluteal tendinopathy (no full-thickness tear), 82% of those given one PRP injection reached a clinically meaningful improvement at 12 weeks, compared with 57% after one cortisone injection.³

Endoscopic gluteus medius repair

For full-thickness tears, or partial tears that don’t improve with non-surgical care, Dr. Dold performs endoscopic repair. Using a camera and a few small incisions, he reattaches the torn tendon to the bone with suture anchors. Larger or retracted tears may need an open repair. When tendon quality is poor, a repair can be reinforced with a collagen-based bioinductive implant.

Dr. Dold is a co-author of a published surgical technique for endoscopic gluteus medius repair augmented with a bioinductive implant (Arthroscopy Techniques, 2016).⁴

What results can you expect after repair?

Most published studies of endoscopic repair are small, but the results are encouraging:

In 15 patients followed for at least 2 years after endoscopic repair, 14 rated their satisfaction as good to excellent.⁵
In another 15 hips with full-thickness tears, the limp caused by hip weakness (a positive Trendelenburg sign) had resolved in all 15 at 2 years.⁶
A systematic review comparing open and endoscopic repair found similar improvements in function, pain and hip strength, with more complications reported after open repair. The authors noted that randomized trials are still needed.⁷

Tendon tissue heals slowly, and some repairs do not heal fully. That is one reason Dr. Dold may reinforce a poor-quality tendon with a bioinductive implant.⁴

Recovery

Tendon-to-bone healing takes time. A typical recovery includes about 6 weeks on crutches with protected weight bearing, followed by progressive strengthening. Most patients continue to improve for 6 to 12 months.

More from the research

Here is what additional studies show, especially about surgery.

Diagnosis

Simple exam findings help identify a tear. A newly described exam test, the “broken wing” sign, was about 80% sensitive and specific for gluteus medius tears. MRI confirms the tear and shows fatty change in the muscle, which matters for planning surgery.

Results of repair

In a series of 112 repairs, about 9 in 10 patients had a successful result. Success rates were highest for less severe tears and lower for the most severe tears. Endoscopic and open repairs both work, with fewer re-tears reported after endoscopic repair, while open repair may be preferred for some large tears with significant fatty change. Improvements after repair have lasted 5 to 10 years in follow-up studies.

Don’t wait too long

Advanced fatty change in the gluteal muscles is linked to less improvement after surgery. If outer hip pain comes with a limp or weakness, an evaluation for a tear is worthwhile.

Why see Dr. Dold

Co-author of a published technique for endoscopic gluteus medius repair augmented with a bioinductive implant (Arthroscopy Techniques, 2016) PubMed
Board certified by the American Board of Orthopaedic Surgery, with subspecialty certification in Sports Medicine
Fellow of the American Orthopaedic Association (FAOA), the American Academy of Orthopaedic Surgeons (FAAOS), the American College of Surgeons (FACS) and the Royal College of Surgeons of Canada (FRCSC)
Sports medicine and arthroscopy fellowship at NYU Langone / Hospital for Joint Diseases; orthopedic residency at the University of Toronto
Member of the International Society for Hip Arthroscopy (ISHA)
D Magazine Best Doctors (Collin County), 2019–2026 · Rated 4.9 on Google

Frequently asked questions

Is it hip bursitis or a gluteus medius tear?

They feel similar. Weakness, a limp, and pain that returns after injections point toward a tear. An MRI tells them apart.

Can a gluteus medius tear heal on its own?

Tendinopathy and some partial tears improve with targeted physical therapy. Full-thickness tears generally don’t heal back to the bone without repair.

Why does my outer hip hurt at night?

Lying on the side compresses the gluteal tendons and bursa. A pillow between the knees and avoiding the painful side can help, but persistent night pain deserves evaluation.

How long is recovery after gluteus medius repair?

Expect about 6 weeks of protected weight bearing on crutches, then months of strengthening. Most patients keep improving for 6 to 12 months.

Is endoscopic repair better than open repair?

Endoscopic repair uses smaller incisions and is well suited to many tears. Large or retracted tears may do better with an open approach. Dr. Dold chooses based on your MRI and tendon quality.

Ready to get your hip checked? Request an appointment online or call 469-850-0680. Our staff will contact you by phone and text within an hour of your request (during business hours, Monday–Friday, 8 am–5 pm). Walk-in visits are welcome Monday, Wednesday and Friday, 8:30–10:30 am. Same-day appointments available. Dr. Dold accepts most major insurance plans, including Medicare and Tricare. Please call 469-850-0680 to confirm your coverage.