Peritrochanteric Access and Gluteus Medius Repair J. W. Thomas Byrd, M.D.  Arthroscopy Techniques  Volume 2, Issue 3, Pages e243-e246 (August 2013) DOI: 10.1016/j.eats.2013.02.014 Copyright © 2013 The Arthroscopy Association of North America Terms and Conditions

Fig 1 In this right hip, 2 anteriorly based portals have been established into the peritrochanteric space, lateral to the greater trochanter, deep to the iliotibial band. Surface markings for the greater trochanter (GT) and vastus lateralis ridge (VLR) are noted, as well as routine markings that would be used for arthroscopy of the central compartment. © J. W. Thomas Byrd. Arthroscopy Techniques 2013 2, e243-e246DOI: (10.1016/j.eats.2013.02.014) Copyright © 2013 The Arthroscopy Association of North America Terms and Conditions

Fig 2 Three laterally based portals have been established for gluteal repair. A viewing portal for the 30° arthroscope is just posterior to the vastus lateralis ridge. A working portal, with an 8.5-mm Clear-Trac cannula, is just posterior to the ridge. Anchors are inserted from a proximal portal, allowing placement perpendicular to the trochanteric cortex. © J. W. Thomas Byrd. Arthroscopy Techniques 2013 2, e243-e246DOI: (10.1016/j.eats.2013.02.014) Copyright © 2013 The Arthroscopy Association of North America Terms and Conditions

Fig 3 A vertically oriented tear of the gluteus medius (arrows) shows the underlying bony footprint (asterisk). © J. W. Thomas Byrd. Arthroscopy Techniques 2013 2, e243-e246DOI: (10.1016/j.eats.2013.02.014) Copyright © 2013 The Arthroscopy Association of North America Terms and Conditions

Fig 4 A triple-loaded 5.5-mm Healicoil anchor is inserted at the proximal aspect of the repair site. © J. W. Thomas Byrd. Arthroscopy Techniques 2013 2, e243-e246DOI: (10.1016/j.eats.2013.02.014) Copyright © 2013 The Arthroscopy Association of North America Terms and Conditions

Fig 5 Viewing down the anchor, the open center shows a conduit from where the tendon will be approximated over the anchor to the underlying marrow products. © J. W. Thomas Byrd. Arthroscopy Techniques 2013 2, e243-e246DOI: (10.1016/j.eats.2013.02.014) Copyright © 2013 The Arthroscopy Association of North America Terms and Conditions

Fig 6 A more distal anchor is being seated. The 3 sutures from the proximal anchor are shown passed through the posterior and anterior leaves of the torn tendon. © J. W. Thomas Byrd. Arthroscopy Techniques 2013 2, e243-e246DOI: (10.1016/j.eats.2013.02.014) Copyright © 2013 The Arthroscopy Association of North America Terms and Conditions

Fig 7 All 6 suture pairs have been passed and are ready to be tied, restoring the tendinous insertion site of the gluteus medius. © J. W. Thomas Byrd. Arthroscopy Techniques 2013 2, e243-e246DOI: (10.1016/j.eats.2013.02.014) Copyright © 2013 The Arthroscopy Association of North America Terms and Conditions

Fig 8 The final repair construct is inspected, with secure approximation of the tendon back to its bony footprint. © J. W. Thomas Byrd. Arthroscopy Techniques 2013 2, e243-e246DOI: (10.1016/j.eats.2013.02.014) Copyright © 2013 The Arthroscopy Association of North America Terms and Conditions