The gluteus medius tendon inserts on two distinct facets of the greater trochanter — the anterior fibres on the superoanterior facet and the posterior fibres on the superoposterior facet. The posterior fibres are the primary site of GTPS tendinopathy and tearing, visible on coronal MRI as signal change and thinning at the superoposterior trochanteric facet. Full-thickness tears of the gluteus medius produce Trendelenburg gait.
Force transmission from the gluteus medius to the greater trochanter; the posterior fibres are most commonly involved in GTPS tears
Gluteus medius tendon repair for full-thickness tears uses suture anchors placed in the greater trochanteric facet, with the tendon reattached through a lateral incision or endoscopically. The technique mirrors rotator cuff repair. PRP injection into the tendon-bone interface combined with rehabilitation reduces pain and improves function in partial tears.
Full-thickness superoposterior facet tendon disruption producing Trendelenburg gait managed with open or endoscopic suture anchor repair.
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