What is the treatment for a partial tear of the gluteus (gluteal) tendons?

From the Guidelines

Treatment for Partial Tear of Gluteus Tendons

Treatment for partial tear of gluteus tendons typically involves a multimodal approach, including physical therapy, pain management, and anti-inflammatory medications, as there is no single treatment that stands out as the most effective based on the provided evidence 1.

• Relative rest and reduced activity are recommended to prevent further damage and promote healing and pain relief, although the duration of rest and avoidance of activity is not clearly defined 1.
• Cryotherapy can provide acute relief of tendinopathy pain, with repeated applications of melting ice water through a wet towel for 10-minute periods being most effective 1.
• Eccentric strengthening is an effective treatment for tendinopathy and may reverse degenerative changes, which can be beneficial for patients with partial tears of the gluteus tendons 1.
• NSAIDs are recommended for short-term pain relief but have no effect on long-term outcomes, with topical NSAIDs being effective and potentially having fewer systemic side effects 1.
• Locally injected corticosteroids may be more effective than oral NSAIDs in acute-phase pain relief but do not alter long-term outcomes, and their use should be considered on a case-by-case basis 1.
• Surgery is an effective option in carefully selected patients who have failed three to six months of conservative therapy, highlighting the importance of a thorough treatment approach before considering surgical intervention 1. Given the lack of specific guidance on the treatment of partial tears of the gluteus tendons in the provided evidence, a conservative approach with physical therapy and pain management is recommended, with the potential addition of PRP injections or corticosteroid injections for patients with persistent symptoms, similar to the treatment of other tendinopathies 1.

From the Research

Treatment Options for Partial Tear of Gluteus Tendons

• The treatment for a partial tear of the gluteus tendons can include non-surgical and surgical options 2, 3, 4.
• Non-surgical options may involve platelet-rich plasma (PRP) injections, which have been shown to be effective in improving pain and function in patients with gluteal tendinopathy 2, 3.
• PRP injections have been compared to corticosteroid injections, with some studies showing that PRP injections may be more effective in the long term 2.
• Another non-surgical option is percutaneous tendon fenestration, which has been shown to be effective in reducing pain and improving function in patients with gluteal tendinosis 3.
• Surgical options may include repair, reconstruction, or tendon transfer, with open and endoscopic repair techniques demonstrating similar outcomes 4.
• The choice of treatment depends on the severity of the tear, the patient's symptoms, and their overall health.

Factors Influencing Treatment Outcomes

• The outcomes of treatment for partial tear of gluteus tendons can be influenced by various factors, including the size and location of the tear, the patient's age and activity level, and the presence of any underlying conditions 4, 5.
• Studies have shown that patients with lower femoral neck-shaft angles and higher acetabular center-edge angles may be more likely to develop gluteus medius tears 5.
• The treatment outcomes can also be influenced by the type of treatment used, with some studies showing that PRP injections may be more effective than corticosteroid injections in the long term 2.

Current Research and Limitations

• The current research on the treatment of partial tear of gluteus tendons is limited, and more studies are needed to determine the most effective treatment options 2, 3, 4.
• The studies that have been conducted have shown promising results for non-surgical and surgical options, but more research is needed to fully understand the outcomes and complications of these treatments 2, 3, 4.
• Further research is also needed to determine the optimal treatment algorithm for patients with partial tear of gluteus tendons, taking into account the size and location of the tear, the patient's symptoms, and their overall health 4.