Hip Bursectomy and Gluteal Tendon Surgery
Overview
Persistent pain over the outer hip is often related to gluteal tendon disease, sometimes with irritation of the nearby bursa. Most people are treated without surgery. Bursectomy, gluteal tendon repair or reconstruction may be considered when a clearly defined problem continues to limit sleep, walking or daily activity despite appropriate rehabilitation. The operation and recovery depend mainly on the condition and repairability of the tendon.
Why might surgery be considered?
Most people with greater trochanteric pain syndrome improve through load modification and a structured strengthening program. Surgery may be discussed when symptoms remain important over time, continue to disrupt sleep or walking and match a structural problem that can reasonably be treated.
A significant gluteus medius or minimus tendon tear may cause weakness, a limp and persistent lateral pain. Other causes of pain, including hip arthritis, lumbar spine disease and referred nerve pain, should be considered before surgery.
Non-surgical options first
- Education about tendon loading and positions that compress the lateral hip.
- A progressive physiotherapy program focusing on gluteal, pelvic and trunk strength.
- Adjustment of work, walking, running and hill or stair loads.
- Pain-relieving or anti-inflammatory medicine after checking that it is suitable for your health and current medicines.
- A selective image-guided injection in some cases. Relief may be temporary, and repeated injection around a damaged tendon requires caution.
What may the operation involve?
The procedure may be performed through keyhole incisions or an open incision, depending on the tear, tissue quality and planned repair. The bursa may be removed to improve access and reduce local irritation. A torn gluteal tendon may be freed and reattached to the greater trochanter—the bony prominence on the outer hip—using anchors. Chronic, retracted or poor-quality tears may require reconstruction and cannot always be repaired directly.
The exact procedure is confirmed from examination, imaging and findings at surgery. A bursectomy does not correct every cause of hip pain, and surgery cannot guarantee restoration of normal strength.
Recovery
Recovery depends mainly on whether a tendon is repaired. After an isolated bursectomy, weight-bearing and movement may progress relatively early. A tendon repair usually needs greater protection with crutches and temporary limits on weight-bearing and active movement of the leg out to the side. Your written postoperative plan takes priority over general timelines.
Physiotherapy usually progresses from protection and mobility to strength, balance and endurance. Improvement is gradual and may continue for many months. Return to work depends on walking demands, lifting, uneven ground, driving and the extent of repair. The individual postoperative plan takes precedence over general timelines.
Risks and limitations
- Infection, bleeding, wound problems or fluid collection.
- Blood clots or medical complications.
- Temporary or permanent numbness, nerve irritation or weakness.
- Persistent pain, limp or incomplete recovery of strength.
- Failure of tendon healing or recurrent tear.
- Stiffness, scar sensitivity or, uncommonly, extra bone forming in the soft tissues around the hip.
- Need for further surgery.
Seek urgent review after surgery
Seek urgent care for fever with increasing wound redness or drainage, rapidly worsening pain, new calf swelling, chest pain, shortness of breath, sudden loss of leg function or a fall followed by marked new pain.
Frequently asked questions
Is bursectomy the same as gluteal tendon repair?
No. Bursectomy removes the bursa. Tendon repair reattaches a torn gluteal tendon. They may be performed together, but the rehabilitation and recovery differ.
Will surgery cure all lateral hip pain?
No. Outcomes depend on the accuracy of the diagnosis, tendon quality, chronicity, general health and rehabilitation. Some pain or weakness may remain.
How long will I use crutches?
This varies. A tendon repair usually requires more protection than an isolated bursectomy. Your written postoperative plan will specify weight-bearing and movement restrictions.
Can a chronic tear always be repaired?
Not always. Retraction, muscle changes and poor tissue quality may limit repair. Alternative reconstruction or continued non-surgical care may be discussed.
General information
This page provides general information only. It cannot diagnose your condition or replace advice from a clinician who has assessed you. Your treatment and recovery plan may differ from the examples described here. Follow the instructions from your treating team. In an emergency, call 000 or attend the nearest emergency department.