Gluteus Max Tendon - Released? Reattached?

Dr. John Rogerson

June 23, 2009  

The upper part of the gluteus maximus tendon should be released in all but the very lax females to take the compression pressure off the sciatic nerve when the leg is maximally internally rotated to expose the head when using the posterior approach.  It should then be re-attached at the time of closure to avoid gluteus weakness and a "saggy" butt (I use an athroscopic anchor with nonabsorbable sutures to repair it).  If the gluteus maximus is not partially released one risks a greater possibility of sciatic injury and foot drop.