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Gluteus Medius Tendon at Greater Trochanter

tendo musculi glutei medii

The gluteus medius tendon inserts onto the posterior and superior facets of the greater trochanter in a complex footprint pattern, with the posterior superior fibres inserting on the posterior facet and the anterior fibres on the lateral facet. The tendon is analogous to the supraspinatus tendon in the shoulder, as gluteus medius is the primary abductor of the hip and its tendon is the dominant component of the hip abductor rotator cuff.

Region: Pelvis & Hip

Clinical Relevance

Clinical Notes

Gluteus medius tendinopathy and tears are the most common cause of greater trochanteric pain syndrome, previously attributed solely to trochanteric bursitis. MRI demonstrates signal change and partial or complete thickness tears at the tendon insertion on the posterior trochanteric facet. Tears are more common in middle-aged women and are associated with a positive Trendelenburg sign. Endoscopic gluteus medius repair reattaches the tendon to the greater trochanter facet using bone anchors through portals posterior to the IT band, analogous to arthroscopic rotator cuff repair.

Pathology

Common Injuries & Conditions

Gluteus Medius Tendon Tear at Greater Trochanter

Partial or complete-thickness gluteus medius tendon tear at the posterior trochanteric facet produces lateral hip pain worsened by lying on the affected side, a positive Trendelenburg sign, and hip abductor weakness; MRI demonstrates the tear extent and fatty atrophy, guiding decision between non-operative management and endoscopic repair.