The gluteus medius inserts via a broad tendon on the lateral surface of the greater trochanter, with anterior fibres inserting on the anterior facet and posterior fibres on the superolateral (lateral) facet. The insertion footprint spans the anterior and superolateral trochanteric facets, with the muscle fibres converging from the iliac wing to this concentrated insertion zone. The gluteus medius tendon is the most commonly torn tendon in greater trochanteric pain syndrome.
Gluteus medius tendinopathy and tears are now recognised as the primary structural pathology in greater trochanteric pain syndrome (GTPS), rather than the previously assumed trochanteric bursitis. MRI demonstrates partial or complete gluteus medius tendon tears at the insertion on the lateral trochanteric facet. Ultrasound-guided corticosteroid injection specifically targeting the gluteus medius tendon provides superior relief compared to simple trochanteric bursa injection. Full-thickness gluteus medius tendon tears are surgically repaired using suture anchors into the trochanteric footprint through an open or endoscopic approach.
Full-thickness gluteus medius tendon tear at the superolateral trochanteric facet produces lateral hip pain with Trendelenburg gait and positive Trendelenburg sign; MRI demonstrates the tendon defect at the insertion with associated trochanteric bone marrow oedema; endoscopic or open tendon repair using suture anchors restores abductor strength and corrects the Trendelenburg gait.
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