Abstract
Introduction
The gluteus medius and minimus play an important role in gait stability and hip abduction. With a partial or complete tear of the gluteal tendons, patients can be debilitated with a wide array of symptoms including Trendelenburg gait or sign, pain, and decreased abduction strength. Among the conservative treatment options, PRP is a commonly used orthobiologic consisting of peripheral blood with a high concentration of platelets and other growth factors. While the efficacy of PRP remains somewhat controversial, a wide array of basic science studies targeting diverse orthopaedic tissues have demonstrated its ability to improve tendon healing.
Case
An otherwise healthy 66 year-old male presented with significant left anterior and lateral groin pain sustained when landing from a jump. His height is 1.75 m, weight is 73.5 kg, and BMI is 23.92 kg/m^2. Physical assessment showed 5/5 strength. MRI indicated a high-grade partial-thickness tear of the gluteus medius and a low-grade partial-thickness tear of the gluteus minimus. One year after Platelet-rich plasma (PRP) injection, the patient experienced resolution of pain and healing of the tendons as shown in a new MRI.
Conclusion
If a patient is not indicated for surgery and has no other significant or relevant comorbidities, PRP injections can yield complete healing of the patient’s partial gluteus medius and minimus tears, allowing patients to return fully to activities of daily living. PRP injections in conjunction with physical therapy remains a viable treatment option for non-surgical candidates. The need for surgery can always be re-evaluated if the patient fails all conservative management.