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Distal lengthening of ilio-tibial band by Z-plasty for treating refractory greater trochanteric pain after total hip arthroplasty (Pedersen–Noor operation)

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The development of greater trochanteric pain (GTP) after total hip arthroplasty (THA) represents a special category. Despite that treatment is mainly conservative, some patients show poor response and surgical intervention should be considered. We propose a new method consisting of distal lengthening of ilio-tibial band (ITB) by Z-plasty.

Material and methods

Between March 2004 and June 2006, 12 women with refractory GTP after THA were operated on using distal ITB lengthening. The procedure was done under local anaesthesia on an outpatient basis. The patients were followed up 3–4 months postoperatively by phone interview and at 1–3 years by EQ-5D questionnaire and clinical examination including tenderness evaluation with algometer.

Results

All patients improved significantly (EQ-5D = 0.26 preoperatively vs. 0.67 postoperatively; P < 0.005) except one patient who experienced no change in GTP symptoms. No postoperative complications were reported.

Conclusion

We believe that treating patients with GTP after THA by the technique described offers a simple, safe and reliable method.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Sundsvall Hospital, 851 86, Sundsvall, Sweden

    Arkan S. Sayed-Noor, Eskild Pedersen & Göran O. Sjödén

  2. Department of Orthopaedic Surgery, Karolinska University Hospital, 171 77, Stockholm, Sweden

    Per Wretenberg

  3. Department of Molecular Medicine and Surgery, Karolinska Institute, 171 77, Stockholm, Sweden

    Per Wretenberg

  4. Department of Surgical and Perioperative Sciences, Norrland University Hospital, 901 85, Umeå, Sweden

    Arkan S. Sayed-Noor & Göran O. Sjödén

Authors
  1. Arkan S. Sayed-Noor
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  2. Eskild Pedersen
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  3. Per Wretenberg
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  4. Göran O. Sjödén
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Corresponding author

Correspondence to Arkan S. Sayed-Noor.

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Sayed-Noor, A.S., Pedersen, E., Wretenberg, P. et al. Distal lengthening of ilio-tibial band by Z-plasty for treating refractory greater trochanteric pain after total hip arthroplasty (Pedersen–Noor operation). Arch Orthop Trauma Surg 129, 597–602 (2009). https://doi.org/10.1007/s00402-008-0693-8

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  • DOI: https://doi.org/10.1007/s00402-008-0693-8

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