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Case Reports
. 2019 Jan-Feb;9(1):6-10.
doi: 10.13107/jocr.2250-0685.1284.

Endoscopic Treatment of Greater Trochanteric Pain Syndrome - A Case Series of 11 Patients

Peter Joachim Bruun Thomassen  1 , Trude Basso  1 , Olav Andreas Foss  1   2
Affiliations
Case Reports

Endoscopic Treatment of Greater Trochanteric Pain Syndrome - A Case Series of 11 Patients

Peter Joachim Bruun Thomassen et al. J Orthop Case Rep. 2019 Jan-Feb.

Abstract

Introduction: Greater trochanteric pain syndrome (GTPS) includes patients with symptoms of peritrochanteric pain, gluteus medius/minimus tendinopathy, and external snapping hip. Non-operative treatment includes iliotibial band (ITB) stretching, gluteal exercises and cortisone injections. When surgery is indicated due to the failure of non-operative strategies, open Z-plasty at the level of the greater trochanter has been the traditional procedure. Endoscopic release of the ITB and bursectomy at the level of the greater trochanter has over the last decades evolved and is established as an alternative method of surgery.

Case reports: We here present a case series with 11 consecutive patients who have undergone endoscopic release of the ITB and bursectomy at the level of the greater trochanter due to GTPS. The patients were all Caucasians, 43-years of age, and six were female. The patients retrospectively scored their pre-operative function and pain during follow-up at 28 months (range 15-42). Post-operative pain and function were scored at follow-up. In this paper, we discuss investigation, differential diagnoses, surgical options, and outcomes in the treatment of GTPS. All patients reported significant reduction of pain, and 10 of 11 patients reported an improvement in function. We observed no complications.

Conclusions: Endoscopic release of the ITB and bursectomy at the level of the greater trochanter appears to be an effective and safe procedure when conservative treatment options for GTPS have failed.

Keywords: Greater trochanteric pain syndrome; Z-plasty; algorithm; endoscopy; iliotibial band.

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Conflict of interest statement

Conflict of Interest: Nil

Figures

Figure 1
Figure 1
(a) Patient placed in the lateral decubitus position, right hip. Viewing portal distal and working portal proximal of needle against apex of the greater trochanter. (b) The 90°vaporizer clearing subcutaneous adipose tissue from the ITB and the needle marking the entry point of the star-shaped release. (c) Star-shaped release of the ITB followed by bursectomy and inspection of m. vastus lateralis and m. gluteus medius.
Algorithm
Algorithm
Algorithm for treatment of greater trochanteric pain syndrome
Figure 2
Figure 2
The pre-operative and post-operative pain and function scores.
See this image and copyright information in PMC

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