Because the implant is not intended to provide immediate strength, the source tissue can be broken down to the collagen fiber level, and then reconstituted into a highly porous structure designed to induce formation of new tendinous tissue. 3, 4 Bovine Achilles tendon is used to construct the implant as it is an abundant source of type I collagen containing minimal of the unwanted impurities (e.g., hair follicles, elastin) commonly found in the dermis-this enables a more pure construct. 3, 4Īn emerging option to augment tendon healing is the use of a bioinductive implant. Open and endoscopic repair approaches have been described, with studies indicating equal symptomatic relief, and fewer postoperative complications for endoscopic techniques.
3 Patients that fail nonoperative management may be indicated for surgery. The first step in management of gluteal medius tears is nonoperative, including physical therapy, activity modification, and nonsteroidal anti-inflammatory drugs. Both injuries most often result from a chronic, degenerative process, with or without a proceeding traumatic event, 1 and are classified as either full- or partial-thickness tears (full-thickness gluteus tears often lead to significant weakness in hip abduction). 1, 2 Gluteal tears are analogous to tears of the rotator cuff-pathophysiologically and clinically. Though historically lateral hip pain has been attributed to trochanteric bursitis, recent studies have recognized tears of the gluteus medius and minimus as an important cause of lateral hip pain.
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