Background

Primary gluteus maximus tendon rupture is a rare injury, with limited studies available in the literature. These injuries tend to occur in an atraumatic and attritional fashion; however, they can occur during sports activities, such as running and jumping. Evidence on treatment options is limited to case reports. These treatment options include nonsurgical management via symptomatic care and primary repair. Primary repair may be a good treatment option for high-grade tears in young, active patients in whom nonsurgical treatment failed. Case studies have reported good outcomes after surgical repair.

Purpose

This video demonstrates primary gluteus maximus tendon repair with the use of Fibertak suture anchors (Arthrex).

Methods

The anatomy of, pathogenesis of, diagnosis of, and treatment options for gluteus maximus ruptures are reviewed. The case presentation of a 19-year-old boy with no medical history who sustained a gluteus maximus rupture is presented. The injury occurred during sports activity (skiing). The injury prevented the patient from performing activities of daily living, and nonsurgical treatment was not well tolerated by the patient. After a thorough discussion of the risks, advantages, and prognosis, the patient elected to proceed with primary gluteus maximus repair to improve his functional status.

Results

The gluteus maximus insertion was anatomically restored intraoperatively. Postoperatively, the repair was maintained clinically. The patient progressed well during recovery.

Conclusion

Primary repair is a viable surgical treatment option for young, active patients with impaired function in whom nonsurgical treatment fails or is not well tolerated. This treatment option can afford good functional results. Adherence to postoperative rehabilitation is crucial for optimal outcomes and to minimize the risk of repair failure.