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. 2024 Aug;34(6):3385-3394.
doi: 10.1007/s00590-024-04019-0. Epub 2024 Jun 11.

Endoscopic management of greater trochanteric pain syndrome (GTPS): a comprehensive systematic review

Riccardo Giai Via  1 , Ahmed Elzeiny  2 , Marco Bufalo  3 , Alessandro Massè  3 , Matteo Giachino  3
Affiliations

Endoscopic management of greater trochanteric pain syndrome (GTPS): a comprehensive systematic review

Riccardo Giai Via et al. Eur J Orthop Surg Traumatol. 2024 Aug.

Abstract

Background: Greater trochanteric pain syndrome (GTPS) presents challenges in clinical management due to its chronic nature and uncertain etiology. Historically attributed to greater trochanteric bursitis, current understanding implicates abductor tendinopathy as the primary cause. Diagnosis usually involves a clinical examination and additional tests such as imaging and provocative testing. Surgical intervention may be considered for cases refractory to conservative therapy, with endoscopic techniques gaining ground over open procedures.

Materials and methods: A systematic review was conducted adhering to the PRISMA guidelines. Relevant studies were searched in four databases: Pubmed, Scopus, Embase, and Medline. The selected articles were evaluated according to the criteria of levels of evidence (LoE). The Coleman methodology score (mCMS) was used to analyze the retrospective studies. This systematic review was registered in the International Prospective Registry of Systematic Reviews.

Results: Surgical success rates ranged from 70.6-100%, significantly improving pain and function. Complications were generally mild, mainly hematomas and seromas, while recurrence rates were low. However, limitations such as the retrospective design and the absence of control groups warrant cautious interpretation of the results.

Conclusions: Endoscopic surgery emerges as a promising option for refractory GTPS, offering effective symptom relief and functional improvement. Despite limitations, these results suggest a favorable risk-benefit profile for endoscopic procedures. Further research is needed, particularly prospective randomized trials, to confirm these findings and optimize surgical techniques to improve patient outcomes.

Keywords: Abductor Tendinopathy; Chronic Hip Pain; Endoscopic Surgery; GTPS; Greater Trochanteric Pain Syndrome; Hip Arthroscopy.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram
Fig. 2
Fig. 2
The Coleman methodology score (mCMS), modified by Ramponi et al. [18]
See this image and copyright information in PMC

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