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Arthroscopic management of greater trochanter pain syndrome and abductor tears has demonstrated promising results in terms of improvement in pain scores and functional outcomes: a scoping review

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Greater trochanteric pain syndrome (GTPS) refers to the constellation of signs and symptoms related to pain in the trochanteric region and has recently replaced the previously ubiquitous term of ‘greater trochanteric bursitis’. GTPS is common, particularly in women 50–79 years of age, and the understanding and management of GTPS have expanded considerably in recent years to include management with arthroscopic and endoscopic techniques in recalcitrant cases. The purpose of this scoping literature review was to summarize the current evidence on arthroscopic management of GTPS including sources of evidence, key concepts, and gaps in the literature.

Methods

A thorough electronic database search included studies published from 2009 to June 14, 2020. A total of 52 peer-reviewed articles were identified within the literature on arthroscopic or endoscopic management of GTPS.

Results

Of the 52 identified papers, 12 were technique descriptions, 10 papers were review articles, and 30 papers were original clinical papers. Of the 30 clinical papers, 24 (80%) were of level IV evidence, 5 (17%) were of level III evidence, and 1 (3%) was level II evidence. Among the 30 clinical studies, 988 patients were included with 761 (77%) female. Indications for surgical management included a failed trial of conservative management in all 30 studies, typically after a period of 3–6 months. Surgical management consisted of arthroscopic/endoscopic abductor tendon repair in 16 (53%) studies, arthroscopic/endoscopic bursectomy and iliotibial band release in 12 (40%) studies, and arthroscopic/endoscopic gluteal tendon contracture release in 2 (7%) studies.

Conclusion

Overall, results following arthroscopic management of GTPS and abductor tears have been promising, including significantly improved pain scores and functional outcomes at final post-operative assessment. These studies support continued use and investigation of arthroscopic management strategies of GTPS and pave the way to conduct larger prospective studies to confirm these results in the future.

Level of evidence

IV.

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Abbreviations

GTPS:

Greater trochanteric pain syndrome

MRI:

Magnetic resonance imaging

PRP:

Platelet-rich plasma

NSAIDS:

Non-steroidal anti-inflammatory drugs

VAS:

Visual analogue scale

mHHS:

Modified Harris Hip Score

HOS:

Hip outcome score

NAHS:

Non-arthritic hip score

iHOT:

International hip outcome tool

MCID:

Minimally clinically important difference

PASS:

Patient acceptable symptomatic state

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Funding

No funding was received for this study.

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Authors and Affiliations

  1. Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 1200 Main St. W. HSC 4E15, Hamilton, ON, L8N 3Z5, Canada

    Jeffrey Kay, Muzammil Memon & Olufemi R. Ayeni

  2. Department of Orthopaedic Surgery, Yitzhak Shamir Medical Center, Zriffin, Israel

    Dror Lindner

  3. Hip Department (CAD), Gaetano Pini, CTO Orthopedic Institute, University of Milan, Milan, Italy

    Filippo Randelli

  4. Tel Aviv University, Tel Aviv, Israel

    Dror Lindner

Authors
  1. Jeffrey Kay
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  2. Muzammil Memon
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  3. Dror Lindner
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  4. Filippo Randelli
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  5. Olufemi R. Ayeni
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Contributions

JK: lead author, contributed to all aspects of the study including study design, data screening, and data analysis and presentation; primary manuscript writer and responsible for all encompassing and all subsequent revisions throughout the editing process. MM: contributed to study design, reviewer responsible for searching, screening and grading data, and contributed to manuscript preparation and revision. DL: content expert, contributed to study design, data analysis, and manuscript preparation and revision. FR: Content expert, contributed to study design, data analysis, and manuscript preparation and revision. ORA: study supervisor and content expert; contributed to all elements of the study, specifically: study design; development of the literature search strategy; assisted with data analysis and presentation; manuscript preparation and revision.

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Correspondence to Olufemi R. Ayeni.

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Kay, J., Memon, M., Lindner, D. et al. Arthroscopic management of greater trochanter pain syndrome and abductor tears has demonstrated promising results in terms of improvement in pain scores and functional outcomes: a scoping review. Knee Surg Sports Traumatol Arthrosc 29, 2401–2407 (2021). https://doi.org/10.1007/s00167-020-06322-9

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  • DOI: https://doi.org/10.1007/s00167-020-06322-9

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