Hip Bursectomy and/or Glute Medius Repair FAQs

What is bursectomy of the hip?

Bursectomy refers to removal of the tissue which covers the bony point of the femur known as the greater trochanter.  This can be performed through arthroscopic or open approaches.  

 

What is a glute medius repair?

Sometimes chronic inflammation, repetitive cortisone injections, or acute injury will lead to the development of tears within one of the gluteal tendons.  The glute medius tendon attaches to the greater trochanter of the femur and is adjacent to the bursae.  If bursitis is resistant to treatment this raises the suspicion there is a tear within the gluteal tendon.  This may cause persistent pain, weakness, and limping.  If the tear is small it is sometimes possible to repair this arthroscopically.  However, larger tears often require an open approach and occasionally autograft or allograft augmentation.  If a gluteal tendon tear is present, a person may have trouble abducting their leg (lateral movement of the leg away from body).  Repair is performed with sutures and anchors, similar to how rotator cuff tears are repaired in the shoulder joint. 

 

How do I know if I need a hip bursectomy and/or glute medius repair?

The recommendation to proceed with surgery is based on a variety of factors including surgeon recommendation, overall health, failure of conservative treatment, as well as future expectations and aspirations.  We believe all of your questions and concerns should be addressed before surgery so that you are comfortable with your decision.

 

What are the risks of surgery?

Risks of surgery include blood clots (DVT/pulmonary embolism), bleeding, infection which can require reoperation, fracture, damage to nerves or blood vessels.  Other risks include chronic hip pain and stiffness as well as potential anesthesia complications such as heart, lung, kidney, and liver damage.   

 

How is my surgery scheduled?

If Dr. Wilson has recommended surgery and you have consented to proceed, you will be contacted by one of our surgery schedulers, and a date for your surgery will be set.  The time of day your surgery occurs is based on many factors and if you have a specific need or request please let them know.  Our surgery scheduler will coordinate insurance authorizations, specialist referrals, post-operative physical therapy appointments, as well as follow-up office visits.  Our surgery scheduler will contact you several days before surgery to inform you what time to arrive for your procedure. You will be provided instructions on bathing/cleansing measures to perform before your surgery.  DO NOT shave your leg for one week prior to surgery.  If you develop any wounds/sores/cuts/scratches/bites around your surgical site please contact our office 48-72 hours prior to surgery to arrange for evaluation.  Failure to do so could result in your surgery being cancelled. 

 

What will I do on the day of surgery?

You may use the free valet parking if desired and signage is marked throughout hospital grounds.  You will present to the outpatient surgery desk on the second floor of the hospital where you will check in.  The receptionist will verify your identification and update any insurance/billing information if necessary.  Following check-in, you will be taken back to a private room where nursing staff will prepare you for surgery.  Your designated family member may be allowed to accompany you once deemed ready by the nursing staff.  An anesthesiologist will examine you and discuss your medical history.  They will also discuss with you options including general or spinal anesthesia, as well as nerve block procedures.  Dr. Wilson and/or his Physician Assistant Adam will see you before surgery and answer any final questions you may have.  Your family/friends will wait in the outpatient surgery lobby while you are in surgery.  Dr. Wilson will call your designated contact upon completion of the surgery to inform them your procedure is complete.  

 

How long will my surgery take and how long will I be in the hospital?

Your procedure will take approximately 1 hour.  Upon leaving the operating suite you will be taken to the PACU(Post Anesthesia Care Unit) for 1-2 hours before being transported back to a prep/recovery room.  This is an outpatient procedure with expectations for discharge home on the day of surgery.  

 

How much pain will I have?

Pain is a subjective measure of discomfort that each individual experiences differently.  Pain control requires a multimodal approach including preoperative nerve blocks, intraoperative local anesthesia, and postoperative oral and/or intravenous medications.  If you have an allergy or intolerance to specific medications this should be mentioned before your surgery.  You will be prescribed narcotic pain medication as outlined in full detail in our office policy on prescribing narcotics.  You will be expected to decrease your narcotic use quickly in the postoperative period.  Dr. Wilson will not prescribe any narcotics beyond 8 weeks post-op and if pain control is still an issue a referral to a pain management specialist may be required.  

 

How long is my recovery?

Each person recovers from surgery differently.  If only a bursectomy is performed there are very few limitations after surgery.  If a glute medius repair is performed It can take up to three months for you to return to most activities, with most patients requiring 6-9 months to obtain maximal strength and endurance.  Your recovery is affected by many factors including dedication with physical therapy, condition before surgery, additional medical problems, and potential postoperative complications.   Return to activities such as driving will depend on which hip is operated on, what type of vehicle you drive, and one’s comfort level and confidence.  In general, driving is acceptable when you can ambulate safely with a cane, enter/exit a vehicle safely, and are no longer taking narcotic pain medication.  You can anticipate using an ambulatory assistive device such as a walker or cane 6-12 weeks post-op if glute medius repair is performed.  The use of assistive devices can help improve gait and balance  while regaining your strength, and decrease the risk of falls. Return to work is based upon your profession and workplace demands.  Someone with a sedentary or office job can often return after only a few days with simple bursecomty, glute medius repair may require 4-6 weeks.  If your job requires frequent walking, standing, lifting, squatting, and/or stairs, 4-6 months recovery may be necessary before you can safely resume working if glute medius repair is performed.  If your employer offers light duty accommodations we can communicate and coordinate with them to accelerate your return.  Traveling is not recommended for at least 2 weeks after surgery, unless it is an emergency.  If traveling is necessary due to an emergency, take frequent breaks and get up to walk around. 

 

What else can I do to prepare for surgery?

We ask that you enroll in MyChart prior to surgery in order to provide a more efficient and effective means of communicating with our office.  Our staff will be happy to help you enroll.  You may be required to obtain medical clearance for surgery based upon your past medical history.  This may entail encounters with your primary care provider or other specialists (allergist, cardiologist, pulmonologist, endocrinologist, etc.) to ensure you are optimized for surgery.  Several tests such as blood and urine samples, x rays, CT scan, MRI, and EKG may be necessary.  Your mobility will be decreased after surgery and preparing your home in advance is helpful to reduce risks of fall or injury.  You will need assistance with daily activities including bathing, cooking, shopping, and laundry.  Removing obstacles such as rugs, cords, chairs, and additional clutter is beneficial.  You will need an assistive device such as a walker or cane and should clear walking paths throughout your home. Purchasing toiletry, food, and wound care items in advance will reduce your or your need for travel outside the home.  Please make arrangements for someone to care for your pets if possible.  In addition, animals pose a potential contamination threat to healing surgical wounds.  Making lifestyle changes prior to your surgery can lessen the chance for complications and improve outcomes.  If you smoke, cut down or quit altogether. Smoking affects blood circulation, delays healing, and slows recovery.  If you drink alcohol, do not consume alcohol for at least 48 hours prior to your surgery.