Biologic Injections During Gluteus Medius Repair and Augmentation
The gluteus medius (GM) muscle is one of the key muscles in the hip, crucial for stability and movement. A gluteus medius tear can involve a tear of the muscle or the tendon, but typically occurs in the tendon that connects the muscle to bone. Tears may be partial or full thickness tears. GM tears are a known cause of dysfunction and disability in older women, negatively impacting quality of life. GM tears tend to be degenerative. GM surgical repair may be performed as open or endoscopic surgery.
Tendon repair involves identifying and removing any damaged or degenerated tissue and reattaching the torn tendon to bone. The ultimate goal of the surgery is to alleviate pain, improve hip function, and restore the patient’s ability to engage in normal activities. To enhance biological response, the bone end is micro punctured to create multiple holes to obtain bone marrow material to stimulate the body’s natural repair mechanisms.
In cases where the tear is severe or complex or the tendon is degenerated, the repair may be augmented or reinforced with tissue grafts to provide extra support and strength to the healing tendon.
Biologics or biologic therapies are biological materials used in the regeneration and repair of bone and soft tissues. They can be implanted or injected.
Biologics or biologic therapies are a class of nondrug treatments that are developed from naturally-derived substances such as sugars, proteins, nucleic acids, and a combination of these substances, or they may be living things such as cells and tissues. They may be used to:
- help accelerate healing of injuries and damage to bone, cartilage, muscles, ligaments and tendons
- improve healing after surgery
There are blood derived therapies such as such as platelet-rich plasma, and cell-based therapies such as stem cells, and bone marrow concentrate.
- Blood-derived therapies such as platelet-rich plasma, deliver cytokines (proteins) that are crucial in controlling the growth and activity of immune and blood cells and control inflammation and healing substances like platelets. Other blood derived therapies include growth factors that stimulate cell mechanisms like collagen production. They are delivered to the site of injury after the completion of the procedure.
- Cellular therapies, such as bone marrow aspirate concentrate (BMAC), have the ability to produce new tissues. They include live cells injected into local tissues. Unlike blood derivatives, cell-based therapies produce a regenerative effect by incorporating them into injured tissues.
Biologic approaches to the treatment of orthopaedic injuries aim to optimize clinical outcomes by improving musculoskeletal tissue healing. Cell therapies with stem cells as well as platelet – rich plasma have been shown to be safe and successful to regenerate and heal bone, cartilage and soft tissues healing.
Biologics that are harvested from your own body and used to treat you are safe. They are not used in people with malignancies or recent remissions.
Schedule a hip consultation
You can rely on experience and qualifications of clinicians at LALL Orthopedics +. Our team aims to provide safe and effective biologics treatments to improve your healing. When you or a loved one is suffering with an orthopedic problem, you have options. Contact the team at LALL Orthopedics + to schedule a consultation to receive the correct diagnosis and modern cutting-edge treatment options. We have offices in New Jersey, Manhattan, Philadelphia, and West Palm Beach, FL.
References
- LaPrade RF, Dragoo JL, Koh JL, Murray IR, Geeslin AG, Chu CR. AAOS Research Symposium Updates and Consensus: Biologic Treatment of Orthopaedic Injuries. J Am Acad Orthop Surg. 2016 Jul;24(7):e62-78. doi: 10.5435/JAAOS-D-16-00086. PMID: 27227987; PMCID: PMC6548434.
- Meghpara MB, Yelton MJ, Glein RM, Malik MS, Rosinsky PJ, Shapira J, Maldonado DR, Ankem HK, Lall AC, Domb BG. Isolated Endoscopic Gluteus Medius Repair Can Achieve Successful Clinical Outcomes at Minimum 2-Year Follow-up. Arthrosc Sports Med Rehabil. 2021 Sep 2;3(6):e1697-e1704. doi: 10.1016/j.asmr.2021.07.026. PMID: 34977622; PMCID: PMC8689210.
- Meghpara MB, Yelton MJ, Annin S, Rosinsky PJ, Shapira J, Maldonado DR, Lall AC, Domb BG. Return to Activity After Gluteus Medius Repair in Active Patients Older Than 50 Years. Orthop J Sports Med. 2021 Jan 27;9(1):2325967120967968. doi: 10.1177/2325967120967968. PMID: 33553438; PMCID: PMC7844460.
- Kruel AVS, Ribeiro LL, Gusmão PD, Huber SC, Lana JFSD. Orthobiologics in the treatment of hip disorders. World J Stem Cells. 2021 Apr 26;13(4):304-316. doi: 10.4252/wjsc.v13.i4.304. PMID: 33959220; PMCID: PMC8080542.
At a Glance
Ajay C. Lall, MD, MS, FAAOS
- Board Certified – Orthopedic Surgery
- Triple Fellowship Trained
- Performs over 750 Surgeries Per Year
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