Iliotibial band Z-lengthening for refractory trochanteric bursitis (greater trochanteric pain syndrome)

Abstract

Background: Trochanteric bursitis or greater trochanter pain syndrome (GTPS) is a frequent cause of lateral hip pain. This article reports our experience with a new method of Z-lengthening of the iliotibial band for refractory GTPS.

Methods: Fifteen patients (17 hips) were diagnosed with GTPS unresponsive to conservative treatment including steroid injection. Fourteen patients were women. The average age was 60 years and average duration of symptoms was 4.7 years.

Results: At the mean follow up of 47 months following Z-lengthening, eight patients reported excellent results with complete resolution of symptoms, eight had good results with symptoms improved and one had a poor result. One patient required secondary repair of a tear in the tendon of gluteus minimus, with a subsequent excellent result. The mean Harris Hip Score improved from 46 to 82.

Conclusion: We recommend this technique in patients with refractory GTPS. Associated tears of gluteus medius or minimus should be identified and repaired at the time of surgery.