Hip dysplasia is a continuum of disease that can present itself early in life as an infant or much later into adulthood as hip pain and or arthritis. Dr. Woyski briefly explains the pathology and treatment of hip dysplasia in adolescents and adults.
Anatomy
The gluteus medius and minimus muscles start at the iliac crest of the pelvis and form tendons that attach to the greater trochanter of the femur (bony knob on the side of your hip).
Gluteus medius Gluteus Minimus
images from www.orthobullets.com
Symptoms
While some may be acute, generally injuries of these muscles develop over time and predominantly affect females. Typical symptoms are pain over the trochanter (bursitis) and when tears are large enough, will present with a limp or (Trendelenburg gait). This is due to the inability of the muscle to balance or keep the pelvis level while walking, which makes the bursitis that much worse. Most patients that present with tears are middle aged females that have had multiple trochanteric hip injections without significant relief of their symptoms.
Treatment
In patients where initial conservative measure have failed including steroid injections, an MRI is typically the next step. MRI helps us evaluate the soft tissues around the hip and lets us see gluteus medius tears. PRP recently has been shown to be effective at both 3 months and 2 years at relieving symptoms and improving function of the hip and may be an important adjunct in the treatment of small partial abductor tears. With MRI evidence of a tear and marked abduction weakness an endoscopic repair may be indicated. Endoscopic repair is also indicated for full thickness tears. In some rare instances the tear can be retracted and muscle atrophy has set in and a salvage procedure such as a gluteus maximus muscle transfer is required for pain relief.
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Hip dysplasia is a continuum of disease that can present itself early in life as an infant or much later into adulthood as hip pain and or arthritis. Dr. Woyski briefly explains the pathology and treatment of hip dysplasia in adolescents and adults.
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