Original Article
Anatomy and Dimensions of the Gluteus Medius Tendon Insertion

https://doi.org/10.1016/j.arthro.2007.11.015Get rights and content

Purpose: The purpose of this study was to determine the area, dimensions, and orientation of the gluteus medius footprint to provide an improved understanding of its insertional anatomy. Methods: Eight fresh-frozen cadaveric hips were dissected, leaving only the most distal gluteus medius tendon attached to the greater trochanter. The tendon insertion footprint and proximal femur were digitized and mapped by use of 3-dimensional computer navigation software. The area, location, and dimensions of the tendon insertion were determined. Results: The gluteus medius tendon has 2 distinct insertion sites on the greater trochanter, the lateral facet and the superoposterior facet. The mean areas of insertion onto the lateral and superoposterior facets were 438.0 mm2 (SD, 57.7 mm2) and 196.5 mm2 (SD, 48.4 mm2), respectively. The lateral facet footprint had a mean longitudinal dimension of 34.8 mm (SD, 4.3 mm), was angled at a mean of 36.8° (SD, 6.7°) relative to the long axis of the femur, and had a mean minimum width of 11.2 mm (SD, 1.8 mm). The superoposterior facet’s shape approximated that of a circle, with a mean diameter of 17 mm (SD, 2.0 mm). Conclusions: The gluteus medius tendon has 2 distinct and consistent insertion sites onto the greater trochanter. This information will provide surgeons with a better understanding of the footprint anatomy when evaluating gluteus medius tendon tears. Clinical Relevance: Gluteus medius tendon tears can be a source of significant pain and morbidity. This study describes the anatomic morphology of this tendon insertion, which should aid in its repair when necessary.

Section snippets

Methods

Eight fresh-frozen cadaveric hips were used. The mean specimen age was 82 years (range, 71 to 91 years). None of the specimens (2 female and 6 male) had undergone prior hip surgery, nor did they have evidence of abductor tears. Each hip was dissected leaving only the most distal portions of the gluteus medius and gluteus minimus tendons attached to the greater trochanter. The most proximal portion of the vastus lateralis was left attached to the vastus ridge. The periphery of each tendon

Results

The gluteus medius tendon inserts into the greater trochanter by way of 2 distinct attachment sites, the superoposterior facet and the lateral facet. The tendinous portion inserting into the superoposterior facet is stout, with a shape approximating that of a least squares circle with a radius of 8.5 mm (SD, 1.0 mm). The surface area of this superoposterior insertion was 196.5 mm2 (SD, 48.4 mm2).

The tendinous portion attaching to the lateral facet of the greater trochanter is more rectangular

Discussion

Tears of the gluteus medius tendon insertion are a recognized cause of recalcitrant lateral-sided hip pain.3 Surgical repair of these tears has been shown to provide symptomatic pain relief and restore abductor function.2 A less invasive arthroscopic approach by which to repair these tears has been proposed18; however, the dimensional characteristics of the gluteus medius footprint are not well understood. The principal findings of our study are that the gluteus medius tendon inserts into the

Conclusions

The gluteus medius tendon has 2 distinct and consistent insertion sites onto the greater trochanter, the lateral facet and the superoposterior facet portions. This information will provide surgeons with a better understanding of the footprint anatomy when evaluating gluteus medius tendon tears.

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    The authors report no conflict of interest.

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