Facing surgery to repair gluteus minimus tear & possible revision
Posted , 40 users are following.
I had a THR in July 2015, and have never yet been able to walk without a limp/pain. I had no limp pre-surgery. My previous thread was titled "22 weeks post-op, still can't walk unaided...".
My orthopedic surgeon has been unable or unwilling to figure out what is wrong, or to even admit that there is a serious problem. He sent me to a physiatrist who ordered a lumbar MRI (no problem found) and did a sacroiliac joint steroid injection (no improvement). Went back to orthopedist and he ordered an MRI, which I had to push him to do, and the radiologist's report said there was a mild strain in the gluteus medius. I told the ortho that I thought I had an actual tear in my gluteus medius or gluteus minimus, and asked about surgery. He says surgery is never done for that. He said to take prednisone and go back to PT to strengthen the weakness in my hip/thigh.
I was unhappy with this, as I know that there is something wrong. More exercise only makes it worse. If it were a mild problem, it would have corrected itself by now. I do walk a fair amount, considering that I use a crutch or walker, and my healthy leg muscles are in good shape. I did a lot of online research about what my problem could be and to find a new doctor.
I saw a new orthopedist yesterday, one who has pioneered methods of gluteal tendon surgical repair. He ordered a bone scan, to rule out prosthesis loosening and infection, and another, better MRI. Again, the radiologist who read the MRI didn't see much, but the orthopedist looked at the scans and DID see evidence of a tear in the gluteus minimus. He says a "tear" is the same thing as "non-healing". The gluteus minimus and medius have to be separated during surgery in order to do the anteriolateral approach that was used on me.
The new doc says that my tear won't get better on its own. It requires surgical repair. He is also wondering if the positioning of my prosthesis might have prevented the healing of the muscle/tendon. So he is sending me to a revision specialist for a consult to see whether he thinks a revision is necessary to reposition things. I see him on Tuesday.
Steeling myself for further surgery. I am tired of being debilitated for 7 months now. Plus I have had a rotten head cold/sinusitis for the past 3½ weeks that has me really down. I had two orthopedist appointments on my birthday, while really sick with this cold, hardly able to speak. I hope I won't need a revision in addition to the tendon repair. Will know soon. Sigh.
Main takeaway: keep pushing for answers if something is wrong.
13 likes, 168 replies
Casey1967 AnnieK
Posted
AnnieK or anyone else who can help. I am DESPERATELY SEEKING HELP for what I know is a GLUTEUS MEDIUS problem, maybe a tear, but I NEED A DOCTOR who knows exactly how to treat this. I just turned 50. For the last TWO YEARS, I have struggled to WALK. I see an excellent "pain doctor" who does injections, RFA, all of that but SPINE only. I have terrible problems in my cervical spine, @T5, all kinds of arthritis, DDD, etc from L2 to the rest of my Lumbar and SI joints. I've had 3 surgeries in the Lumbar area, a laminectomy/discectomy at 4-5, which, as you all know, only helped with the radiculopathy in my leg and I am thankful but I have lots of other issues that have plagued me since 1994. Crazy "athletic" lifestyle up until 1997 when I was in a car wreck that created the last straw. I loved my job as an RN in the Operating Room, running (of all things!) the neuro-spine service. I know a lot about the spine, but there's plenty I don't know and some of it will probably always remain unknown. FINALLY, after much research and much "complaining" to different docs, I am 100% sure that I have a big, bad problem either originating from my left GLUTEUS MEDIUS muscle (or one that greatly affects it). I NEED HELP. The effect this has had on my life is profound. I can take a lot. I'm "tough", have a high pain threshold and tolerance, but THIS HAS A FIRM GRASP on me and my well-being, physically and mentally. I live in Searcy, ARKANSAS, close to Little Rock and would love to find a physician who is knowledgeable about my problem. I'm so tired of being blown off and treated for all kinds of things that get close, but never have had anyone even mention this muscle to me. I CANNOT WALK very far at all without being stopped, right in my tracks because of the stabbing, SEVERE pain that walking causes. It seems like the pain that would come from a torn muscle. Also, when I can apply enough pressure to push that muscle "in", I get significant relief. I am grateful and appreciate that I don't have problems worse than this. I have been largely at fault for not "complaining enough" to my doctor, so that he would investigate more or refer me to someone who knows about this.
Casey1967 AnnieK
Posted
SO...I and done just taking it and accepting that this is just how my life is going to be now. PLEASE HELP ME FIND A DOCTOR and/or SURGEON. If I can't find one in Arkansas, I will go elsewhere. Does anybody have any suggestions or advice? THANK YOU so much, in advance. I feel hopeful for the first time in a long time. I cried when I finally found a website that exactly describes my problem. I did not think that would ever happen, as I have searched for a long time and found nothing. THANK GOD I finally know.
AnnieK, I would love to know how you are doing!
AnnieK Casey1967
Posted
Casey, I am so sorry for your pain and disability and difficulty finding a medical professional who can properly diagnose and treat your problem. Here is the link to my recovery thread, from the time I had the gluteus repair surgery and afterwards. https://patient.info/forums/discuss/having-gluteus-medius-repair-surgery-possible-hip-revision-tomorrow--543982 It describes everything I went through right up until now. Currently I am one year post-op and doing very well. I have only minimal hip pain, and have regained much strength and stability in my surgical leg. I don't know if I will ever be fully as strong on that side as on the other (non-surgical) side, but it is so much better than before the surgery.
I will personal message you the information about the surgeon I found and his practice. There is a lot of good info on his website about gluteus medius problems, surgical repair and post-op recovery and protocols for eventual physical therapy. I am in a suburb of Chicago. I don't know of any surgeons who could help you any closer to your home.
I urge you to post your own thread here on Patient. Just click on the dark rectangle on the bottom left of the page (or towards the top of the page on the right) that says "Start Your Own Discussion." You may attract more attention that way and get more replies. It is pretty rare that a gluteus medius tendon tear gets correctly diagnosed, and most people don't even know they have the tear. I believe it is much more common than is realized because of that. And many orthopedists don't seem to be knowledgeable about this condition.
Best of luck to you. I'll send you that personal message soon.
victoria58146 AnnieK
Posted
Update on your progress? Hope all went soothly in this difficult situation. I feel I've been misdiagnosed. Looking for cure of major Hip pain in Northern Calif. SF Bay area.
AnnieK victoria58146
Posted
Hello, Victoria! I posted about my surgery and recovery in this thread:
https://patient.info/forums/discuss/having-gluteus-medius-repair-surgery-possible-hip-revision-tomorrow--543982
It is now 15 months since the gluteal tendon repair surgery, and I am much better off than before. I can walk well without much of a limp. I can balance on the surgical leg. I still have some weakness and some pain in that hip, but it is tolerable, and I am glad I had the surgery. If, after checking out the thread above you still have questions, please let me know.
Have you had any additional opinions as to your condition? I've seen on a number of occasions that a second or even third opinion from a physician has made all the difference for a correct diagnosis. Good luck!
victoria58146 AnnieK
Posted
So glad to hear you're not in so much pain anymore, and not limping so much!
I am a Kaiser member in Northern California right now, ...looking into getting out of Kaiser.
Need to find the best chronic hip surgeon around.
I have seen 3 orthopedic surgeons who do acute hamstring tears but not chronic ones. Orthopedic medicine doctor wouldn't let me have an MRI for eight months... claiming they thought it was a partial tear and would heal. When I got the MRI it showed a full thickness tear retracted. The scar tissue was built up around the hamstring and the sciatic nerve and they said it was too dangerous to operate on, said if sciatic nerve was touched I could be paralyzed. Less than 50% chance of improvement, and could be worse.
MRI also showed a partially torn gluteus minimus tendon, This happened 2 years ago, overusing my left leg on stairs, because of an unhappy TKR on right side. It's been painful to sit, or walk, really hard to go up or down, or bend over...or sleep.
The last several months my lateral hip area has gotten really sore especially when I walk, or lie on either side. They say it is the bursa that is causing the pain, and want to inject it with Cortizone, but I am concerned that that breaks down soft tissue and with the muscle tears might hurt things further.
I also have a lot of back pain,.. major scoliosis, stenosis of the foramina, disc degeneration.. Haven't gotten an epidural yet, but I am considering it.
If anyone knows of the very best hip surgeon around let me know! I'm in San Francisco Bay Area.
Lately I've put so much weight on the cane on my right side that I pulled a muscle in my rib. ;-(
Getting to be quite an unhappy camper. Using a walker now, and that is helping with the rib. Was very interested to find this site and your blog when I copied and pasted my condition in the browser.
Thank you… And keep healing!
cristina21185 AnnieK
Posted
Hello, my name is Cristina and ive just gotten my mri results back. For the past year or so I've felt some left sided hip pain and I always wrote it off as "arthritic" pains. I was diagnosed with fibromyalgia when I was 32 and the year prior to that I was diagnosed with Perimenopause. Yes, menopauae at 31yrs of age. So, of course my bone density scan also showed osteopenia. (Smh)
2 weeks ago, I fell off my kitchen chair and landed on my left hip. (The one that always felt kind of off) Well, I didn't feel any pain or bruising so the next day I started my excersie regimen which consists of speed walking, jogging, and abdominals. 1st day after my call i did 2 miles, 2nd day I did 3 miles, the 3 rd day I did 2 miles and and atopped because I started to feel a deep throbbing pain in my left hip which radiated down to my knee.
The following day I went to work and couldn't sit all day so I kept fussing about. The pain had now radiated to my left buttock and lower back with some sharp stabbing pains here and there. I work for an orthopedic clinic with multiple specialists so I decided to see a spine specialist. ( my cervical spine was hurting and I figured I'd see the doc and also tell him aboit my hip)
After a physical exam he diagnosed me with left hip bursitis and gave me a cortisone injection. I started mobic daily and flexeril at night time.
1 week later I had 3 MRI tests.
Cervical showed DDD
Lumbar showed 2 herniated discs
Left hip showed :
Greater Trochanteric Bursitis
A tear at the base of the left anterior labrum
Left hamstring tendinosis
Gluteus medius tendinosis
And of course gluteus minimus tendinosis WITH a low grade Partial Thickness Tear.
I see the same doc in 1 day and ive done so much research about the GM tear and I am petrified of requiring surgery. I havent worked there for 1 year so FML is out of the question, I live in a basement apartment which requires walking up and down a flight of stairs, and I am the only bread winner of my household.
(My 24yr old son lives with me and goes to college full-time)
From what ive read, people have been living with these tears for years since they were not diagnosed properly and then had the surgery. The recovery time is a long time and I cannot afford to take time off from work and risk losing my employment.
I was thinking of taking it easy ( non to partial weight bearing and limited activity ) until I can qualify for FML ( 6 more months) but not sure if it's a wise decision. I dont think I have a choice truthfully, but to wait.
Another thing that scares me is that my MRI was without contrast so what if it didnt show the true extent of the year?
I need some encouraging words because I am losing hope.
AnnieK cristina21185
Posted
Cristina, oh my, what a number of problems you have with your hip and spine!
I went 15 months between my gluteus medius and minimus tendon tears until I had surgery to repair them. My MRIs also were without contrast, but my ortho surgeon was able to diagnose the tears from the scans, as well as from the physical exam and extent of my disability. I was completely unable to balance alone on my affected leg, even for a part of a second. My leg would simply collapse out from under me when I tried. It never got better. Now, 17 months post-op, I can balance on that leg just fine. I am not 100% in terms of strength in that leg, and at age 70, I don't really care. I can do what I need and want to do in terms of physical activity.
Can you balance at all on your leg alone? Whether surgery is recommended depends on the severity of the tear(s). And how bad is your labral tear? Those can be quite debilitating in terms of pain and disability of the hip. And you have all of that tendinosis in various places. How well do you walk?
I think your idea to take it easy until you can qualify for FML is a good one. At the very least, it might ease the tendinosis in the several areas. And it would ease your mind financially a bit, too.
For me, the choice to have the surgery was an easy one. First, I couldn't walk without a lot of pain and limping, even when using walking aids. Second, it wasn't going to get better on its own. And, third, I was 69 and retired, no dependents, and I had plenty of support for recovery from my husband and sister, who lives next door to me.
You have different considerations, to be sure. Make sure the doctor is aware of all of your pain(s) and disabilities in terms of walking and functioning. He'll give his best recommendation. Ask him questions - I never went to see a doctor without a list of questions, so that I wouldn't forget anything. And don't be shy about getting a second opinion. Best of luck to you in getting the treatment that you need, Cristina!
Another of my threads tells what I went through in recovery after the glute tendon repairs, in case you are interested. https://patient.info/forums/discuss/having-gluteus-medius-repair-surgery-possible-hip-revision-tomorrow--543982
lynne31913 AnnieK
Posted
AnnieK lynne31913
Posted
Lynne, I responded via personal message. Let me know if you didn't receive it.
Shay3r AnnieK
Posted
Hi Annie,
It has been a while since I have been on here. I have been keeping busy.
I joined a gym a few months ago to use the pool to do more hip strengthening. I also use the weight equipment. Like the hip abuctor, leg press, and glute. Since I have began this, my hip pain has returned. It has been since the end of June that I had my surgery. As far as I know, i did not overdo anything. Even when I had therapy it hurt to abduct. I'm really worried that I have retorn. Or I'm wondering if my surgeon missed it. My MRI said my glute min was torn, but when he went in he only found my labrum torn and the cartilage damage. He said he looked for 45 mins and did not find a glute tear. I'm so depressed now. I went through 6 weeks no weight bearing and now have no feeling above my knee due to the brace. The brace was not fitted properly and the heavy metal part laid on my thigh above my knee and I guess it killed my nerves. And now I'm getting pains again just as before the surgery. Im lost what to do now. I don't know if my insurance will allow me a new MRI. I'm currently appealing them denying my surgery after the fact. I tried to ride my bike today. I still have butt pain sitting on the seat. That was my favorite form of exercise. I have now gained quite a bit of weight because I can't do anything. I'm not a good swimmer and doing just one lap with my head above the water is all I can do before I'm winded. I'm so lost trying to fix this.
AnnieK Shay3r
Posted
Oh, Shay, I am so sorry to hear all of this! They denied payment for your surgery afterwards? Had they approved it before?
Did the surgeon repair the labral tear when he was in there? I wonder why he thought your glute min tendon was torn. Perhaps he saw atrophy in the gluteus minimus muscle. And you have pain again and are numb above the knee due to the brace. I really understand how you feel so lost. I hope you will keep on contacting professionals, describing your pains and disabilities, and pushing for proper diagnoses and treatment. If it were me, I would definitely hold off on those hip strengthening weight equipment, since it caused the pain to return. Swimming might hurt it too, and even though you say you aren't a good swimmer, you could find out by concentrating on that and trying to get better at it.
Hope you can find the strength to keep going, Shay, trying to find out the answers that will help you.
Shay3r AnnieK
Posted
Yes, he repaired the labrum tear and did microfracture for the cartilage damage. My insurance did not get all the documentation prior to because I did not have them until a few months prior. There was no pre auth required. I called my doc office after and I have no idea if the appeal has gone in my favor yet. They should give the insurance all the documentation and I hope they approve it. I tried pt and cortisone injection be4 hand and it didn't help.
I hope they will give me another MRI to find out what's going on now.
AnnieK Shay3r
Posted
aunt_bevie AnnieK
Posted
Hi AnnieK
I, too, am facing gluteus minimum repair. I had a THR on the opposite side 3 years ago which went off without a hitch. Recovery was fairly easy. But I am nervous about this surgery. My orthopod says this will be much more painful than a replacement and the there's the 6 week non-weight baring period. I have steps in my home and am making arrangements to stay on the first floor. I will have to rent a hospital bed. Did you have your repair? I am anxious to know how it went.
aunt bevie
AnnieK aunt_bevie
Posted
Aunt Bevie, best wishes for your surgery. I am surprised at what your orthopedist said, since it was my experience that the repairs of my gluteus medius and minimus tendons was much less painful and difficult than my THR was. Other than whatever they give you during surgery for the pain, and for a few days afterwards, I only needed acetaminophen. I was on opioids for 5 weeks after my THR! I also needed some muscle relaxants after the tendon repair, since I did get some thigh muscle cramping. Here is my thread about the recovery: https://patient.info/forums/discuss/having-gluteus-medius-repair-surgery-possible-hip-revision-tomorrow--543982
Also I did not have non-weight bearing. I had toe-touch 25 pound weight bearing for 6 weeks. That made it easy for me to get around using a walker. I also have a hospital bed, which came in very handy, and an electric lift recliner, that I use all the time, even now.
I feel very good these days, although the surgical leg has never gotten as strong as my other leg is. Most of my current problems are because of issues with osteoporosis of my spine and vertebral fractures. I am VERY glad that I had the tendon repairs, because if I hadn't, I would still have lots of pain and terrible limp and have to use walking aids at all times. Not the case now!