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Does a full tear of the gluteus minimus tendon result in a long-lasting inflammatory response?

This answer mentions:

An isolated gluteus minimus tear still causes functional problems because of the associated inflammatory response

But I read on {1}:

“signs of either acute or chronic inflammation have not been found in any surgical pathologic specimens in patients with clinically diagnosed lateral tennis elbow syndrome,”

Note that tendon tears are present in a tennis elbow (a.k.a. lateral epicondylopathy). From {2}:

Review of MRI findings from 24 patients with epicondylitis reported increased intratendon signal on both T1 and T2 pulse sequences58 with occasional bone marrow edema pattern in the epicondyle. Other studies have shown thickening, edema, and tears of the common extensor tendon.

References:

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    $\begingroup$ Why are you comparing a non-tear injury (tennis elbow) to a full tear of a tendon (gluteus minimus)? $\endgroup$
    – Charles E. Grant
    Jun 2, 2019 at 1:42
  • $\begingroup$ @CharlesE.Grant tennis elbow is micro tear $\endgroup$
    – Franck Dernoncourt
    Jun 2, 2019 at 1:44
  • $\begingroup$ Micro-tear seems very different then a full tear. $\endgroup$
    – Charles E. Grant
    Jun 2, 2019 at 1:45
  • $\begingroup$ @CharlesE.Grant I don't know whether the difference impact the inflammatory response $\endgroup$
    – Franck Dernoncourt
    Jun 2, 2019 at 1:48

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The article you linked is interesting, but as @Charles E. Grant mentioned in the comments, it’s not particularly reasonable to compare a non-tear repetitive stress injury (like epicondylitis) to a full muscle tear. Non-tear repetitive stress injuries persist because the offending frequent motion doesn’t stop. A muscle tear, however, will recruit an inflammatory response that will eventually be resolved by anti-inflammatory factors (Th2 cells directing the cellular microenvironment towards healing / scarring).

This healing process might not result in an optimal resolution of the initial injury, and it’s not unique to any particular body system. Rather, pretty much anything in your body that can be injured will first respond with a period of innate inflammation followed by fibrosis and resolution (whether or not that restores function / alleviates pain depends on a number of factors including injury severity, therapeutic management, and healing conditions e.g. if there were repeated injuries during the healing process).

With regard to gluteus minimus tears — it depends on the injury. If a patient persistently aggravates an already-torn muscle, they will have more inflammatory cells recruited to the injury. If they do a good job allowing the injury to heal (not re-aggravating the injury, receiving surgery if structural correction is required), the inflammatory process will resolve relatively quickly.

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  • $\begingroup$ Thanks. As mentioned in my comment in reply to @Charles E. Grant, tendon tears are present in an epicondylopathy (and more generally, any tendinopathy resulting from repetitive stress). I have added one reference supporting this statement in the question. I believe there is a consensus from the medical community on this. $\endgroup$
    – Franck Dernoncourt
    Jun 2, 2019 at 4:59
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    $\begingroup$ I think your second reference essentially corroborates what I’ve written above: “Four stages of lateral epicondylitis have been described, beginning with the early inflammatory reaction, followed by angiofibroblastic degeneration, structural failure, and ultimately, fibrosis or calcification.” $\endgroup$
    – Bruce Kirkpatrick
    Jun 2, 2019 at 5:14
  • $\begingroup$ That's correct, I agree with the rest of your answer. I'll add another follow-up question tomorrow. $\endgroup$
    – Franck Dernoncourt
    Jun 2, 2019 at 5:17
  • $\begingroup$ Follow-up question: Can an individual further aggravate a full tear of the gluteus minimus tendon (trochanter insertion)? Your insights are welcome! $\endgroup$
    – Franck Dernoncourt
    Jun 3, 2019 at 4:05

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