Physical findings differ between individuals with greater trochanteric pain syndrome and healthy controls: A systematic review with meta-analysis

Abstract

Background: Understanding of the biopsychosocial characteristics of greater trochanteric pain syndrome (GTPS), a prevalent lower limb tendinopathy, is currently lacking.

Objectives: To quantify differences in participant characteristics between individuals with GTPS and healthy control participants.

Design: Systematic review of original studies with meta-analyses where appropriate.

Methods: A comprehensive electronic search was undertaken in Pubmed, EMBASE, Web of Science and CINAHL for terms referring to GTPS. Studies that provided comparison of individuals with clinically characterized GTPS with healthy controls were included. Study quality was rated with the Joanna Briggs Institute Critical Appraisal Checklist for Cross Sectional Studies. Standardized mean differences were calculated and supported by narrative synthesis or meta-analyses where appropriate. Certainty of evidence was assessed based on the GRADE guidelines.

Results: The search revealed 2798 studies, of which 13 studies from five research groups were included. There were 229 participants with at least three months duration of GTPS and 193 control participants. Individuals with GTPS displayed larger greater trochanteric width, greater body mass index, lower hip abductor muscle strength, higher hip abductor muscle activity, altered single leg loading and gait parameters including shorter step length and velocity. No studies investigating psychological features or sensory perception were identified. Quality of life was investigated in a single study.

Conclusions: Compared to healthy controls, participants with GTPS are more overweight, have poorer hip abductor muscle function and altered gait parameters. Overall quality of evidence across studies was very low based on GRADE guidelines.

Keywords: Chronic pain; Gluteal tendinopathy; Hip; Lateral hip pain.