With chronic tears, the tendons may retract, and the muscles may atrophy, with nothing left to repair. However, all is not lost. Even in these circumstances, when the symptoms are disabling, reconstructive methods are available. This involves taking a portion of the gluteus maximus tendon from the back and the tensor fascia lata from the front and bringing them together over the greater trochanter to recreate the abductor group. While this involves an open technique, it can be very effective in the right circumstances.
Rehabilitation following abductor tendon surgery is prolonged. (Related Study: Rehabilitation of the Hip) It is certainly worth it in the face of disabling symptoms, but is a procedure for which the patient needs to be prepared to dedicate themselves to the postoperative rehabilitation process. Crutches or a walker are necessary for 6-8 weeks, with ongoing precautions to protect the repair site for the first 4 months. Typically, it takes about 6 months to really get beyond the surgery and appreciate the benefits.