Prevalence of Gluteus Medius Pathology on MRI in Patients Undergoing Hip Arthroscopy for Femoroacetabular Impingement: Asymptomatic Tears Are Rare, Whereas Tendinosis Is Common
Authors
Meghpara MB, Bheem R, Shah S, Shapira J, Maldonado DR, Rosinsky PJ, Lall AC, Domb BG
DOI: 10.1177/0363546520952766
Background
Gluteus medius pathology is common in patients with femoroacetabular impingement (FAI), but it's unclear how often these conditions are asymptomatic. This study examines the prevalence of asymptomatic gluteus medius pathology in FAI patients.
Methods
The study reviewed MRI results of 2,851 hips from 2,452 patients who underwent hip arthroscopy. The prevalence of gluteus medius tendinosis and tears was analyzed, as well as the association with symptoms like hip tenderness and weakness.
Key Findings
30.6% of hips showed gluteus medius pathology, with 16% being asymptomatic.
Asymptomatic cases were more likely to involve tendinosis rather than tears, and patients with partial-thickness tears were significantly older than those with only tendinosis.
No patients with full-thickness tears were asymptomatic.
Conclusions
Gluteus medius tendinosis is common and often asymptomatic, while tears (especially full-thickness) are rarely asymptomatic. Clinical evaluation should guide treatment, rather than relying solely on MRI findings.
What Does This Mean for Patients
If you're undergoing hip arthroscopy for FAI, asymptomatic gluteus medius pathology, especially tendinosis, is common and may not need treatment. However, tears, particularly full-thickness ones, are more likely to cause symptoms and require attention.