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Gluteus Medius Tear
Dee Dee Ostman always prided herself on being in good shape. “I watch my diet, go to yoga three times a week, and run daily.” A couple years ago in February, she came across an article that included a self-assessment test to indicate your longevity and health. The test involved sitting cross-legged and raising yourself to a standing position without holding on to anything. She said she was pleased with her completion of the test but then felt a pop in her hip area as she rose. She dismissed it because there was no pain associated with the pop. She recalls being sore the next day but regardless went for her daily run. Over the next few days the soreness increased to the point she was not able to go on her daily runs and after a few weeks the soreness had turned to pain. Her primary care doctor said it could be bursitis which is the inflammation of the fluid filled sacs that cushion the joints. Dee Dee was told to take prescription ibuprofen and was given a list of exercises to do at home. After another three weeks and still no improvement, Dee Dee was sent to physical therapy.
After three weeks of physical therapy, she was in less pain but still not able to run. Over the summer, Dee Dee and her husband went on a vacation and says afterwards she felt great. Her pain had drastically decreased. She credited her improvement on the sun and the sand and was able to return to yoga although some of the positions still hurt.
In October, Dee Dee’s pain and discomfort returned and she asked to be referred to an orthopedic specialist. The first orthopedic specialist informed her that she had ruptured two-thirds of her gluteus medius tendon. She was told she was being referred to another orthopedic physician because that surgeon did not specialize in that type of injury. At her appointment with her the second orthopedic surgeon, she was yet again told they would not be able to perform surgery and was referred to a third orthopedic specialist. The third and final doctor wouldn’t even see her — after reviewing her MRI, he recommended she see Cecilia Pascual-Garrido, MD, PhD, a Washington University Orthopedic specialist in Joint Preservation and Adult Reconstruction, at Barnes-Jewish Hospital and Barnes Jewish West County Hospital.
Dr. Pascual says, “Glut tears are a common pathology observed in the adult population. They are normally observed in patients treated with several steroid injections for the treatment of bursitis. For many years, the treatments of glut tears were ignored or were treated non-operatively. Patients’ pain would improve, but they would end up with a severe limp. Today, we have made tremendous improvement in the diagnosis and treatment of this disease. We treat our patients with a minimally-invasive approach, in an outpatient setting. Our patients fully recover by three to six months post-surgery.”
Dee Dee recalls being told that if she did not have the surgery she could end up with a complete tear and she’d eventually walk with a limp that would affect the rest of her body.
“The outcome of this surgery is really good. The pain normally improves immediately and by six months most of the patients will not have a limp anymore,” says Dr. Pascual.
Dee Dee says the first three weeks of her recovery were so easy. She was not able to bear weight and had to wear a brace but had no pain. She recalls taking full advantage of the time. “I read books and organized pictures of my kids. I believe it was the most enjoyable recovery from surgery ever.”
Physical therapy was the only time she experienced any kind of pain or discomfort. She recalls being very nervous about re-injuring herself but Dr. Pascual was so compassionate. “I was so used to being active and now had to be careful. Dr. Pascual was always reassuring and explained it would take time to fully heal. I always felt better and more confident when leaving her office.”
One year post surgery, Dee Dee has almost all of her flexibility and strength back. She could not be more pleased with the outcome. “Dr. Pascual and Barnes-Jewish Hospital as a whole are a class act. Dr. Pascual, her medical staff and staff at the hospital were always friendly and going out of their way to help us. I felt like I was listened to and in very kind and capable hands. I was a recipient of great overall care by everyone involved.”
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