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Greater Trochanteric Pain

Jay R Ebert, Theertha Retheesh, Rinky Mutreja, Gregory C Janes
BACKGROUND: Hip abductor tendon (HAT) tearing is commonly implicated in greater trochanteric pain syndrome (GTPS), though limited information exists on the disability associated with this condition and specific presentation of these patients. PURPOSE: To describe the clinical, functional and biomechanical presentation of patients with symptomatic HAT tears. Secondary purposes were to investigate the association between these clinical and functional measures, and to compare the pain and disability reported by HAT tear patients to those with end-stage hip osteoarthritis (OA)...
October 2016: International Journal of Sports Physical Therapy
Tarek M Hegazi, Jeffrey A Belair, Eoghan J McCarthy, Johannes B Roedl, William B Morrison
Injuries of the hip and surrounding structures represent a complex and commonly encountered scenario in athletes, with improper diagnosis serving as a cause of delayed return to play or progression to a more serious injury. As such, radiologists play an essential role in guiding management of athletic injuries. Familiarity with hip anatomy and the advantages and limitations of various imaging modalities is of paramount importance for accurate and timely diagnosis. Magnetic resonance (MR) imaging is often the modality of choice for evaluating many of the injuries discussed, although preliminary evaluation with conventional radiography and use of other imaging modalities such as ultrasonography (US), computed tomography, and bone scintigraphy may be supplementary or preferred in certain situations...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Jon A Jacobson, Corrie M Yablon, P Troy Henning, Irene S Kazmers, Andrew Urquhart, Brian Hallstrom, Asheesh Bedi, Aishwarya Parameswaran
OBJECTIVES: The purpose of this study was to compare ultrasound-guided percutaneous tendon fenestration to platelet-rich plasma (PRP) injection for treatment of greater trochanteric pain syndrome. METHODS: After Institutional Review Board approval was obtained, patients with symptoms of greater trochanteric pain syndrome and ultrasound findings of gluteal tendinosis or a partial tear (<50% depth) were blinded and treated with ultrasound-guided fenestration or autologous PRP injection of the abnormal tendon...
September 23, 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
James Drummond, Camdon Fary, Phong Tran
INTRODUCTION: Greater trochanteric pain syndrome (GTPS), previously referred as trochanteric bursitis, is a debilitating condition characterised by chronic lateral hip pain. The syndrome is thought to relate to gluteal tendinopathy, with most cases responding to non-operative treatment. A number of open and endoscopic surgical techniques targeting the iliotibial band, trochanteric bursa and gluteal tendons have, however, been described for severe recalcitrant cases. We report the outcomes of one such endoscopic approach here...
July 12, 2016: Archives of Orthopaedic and Trauma Surgery
U Dorn, F Landauer, T Hofstaedter
Gluteal tendinopathy as well as partial and full-thickness tears of gluteal tendons (gluteus minimus and/or medius tendon) were underestimated as a cause of chronic pain in the past, and treatment was most commonly based on the diagnosis of trochanteric bursitis. Tendinous pathologies can either stay asymptomatic or cause pain and muscular dysfunction, not necessarily being associated with osteoarthritis of the hip 1. As the terminus "rotator cuff tear of the hip" was published in 1997 2, its aetiopathogenesis was reconsidered, resulting in improvements in diagnosis and treatment...
June 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Charlotte Ganderton, Adam Semciw, Jill Cook, Tania Pizzari
BACKGROUND: Greater trochanteric pain syndrome (GTPS) is pathology in the gluteus medius and minimus tendons and trochanteric bursa that causes debilitating tendon pain and dysfunction, particularly in post-menopausal women. Limited evidence in clinical studies suggests hormone changes after menopause may have a negative effect on tendon. This protocol describes a randomised controlled trial comparing the effectiveness of menopausal hormone therapy (MHT) and exercise therapy in reducing pain and dysfunction associated with GTPS in post-menopausal women...
2016: BMC Women's Health
Belma Füsun Köseoğlu, Sinem Akselim, Bilge Kesikburun, Özge Ortabozkoyun
BACKGROUND: The presence of lower extremity pain may be associated with poorer motor recovery, impaired activities of daily living (ADL), reduced quality of life, and disability in patients with stroke. OBJECTIVE: The aims of the study were to describe the characteristics of lower extremity pain conditions and to evaluate the impact of lower extremity pain on clinical variables, and health-related quality of life in patients with stroke. METHODS: One hundred and eighty-five patients with stroke who have self-reported pain in the lower extremity were included in the study...
May 30, 2016: Topics in Stroke Rehabilitation
Ki Deok Park, Woo Yong Lee, Jihae Lee, Min-Ho Park, Jae Ki Ahn, Yongbum Park
BACKGROUND: Trochanteric bursa injections of corticosteroids and local anesthetics have been shown to provide pain relief for the treatment of greater trochanteric pain syndrome (GTPS). However, symptom recurrence and incomplete symptom relief are common. The reason for the variation in response is unclear but may be related to disease-, treatment-, or patient-related factors. OBJECTIVE: To determine whether there are factors related to patient, treatment, or disease that can predict either the magnitude or duration of response to ultrasound-guided trochanteric bursa injections for GTPS...
May 2016: Pain Physician
Scott W Cheatham
There is growing subgroup of patients with poor outcomes after hip arthroscopy for intra-articular pathology suggesting unrecognized cause(s) of impingement may exist. Extra-articular hip impingement (EHI) is an emerging group of conditions that have been associated with intra-articular causes of impingement and may be an unrecognized source of pain. EHI is caused by abnormal contact between the extra-articular regions of the proximal femur and pelvis. This review discusses the most common forms for EHI including: central iliopsoas impingement, subspine impingement, ischiofemoral impingement, and greater trochanteric-pelvic impingement...
March 2016: Journal of the Canadian Chiropractic Association
Long Qin, Zexing Zhu, Diyu Song, Jianqiang Xu, Hao Yu, Shuming Zhang
OBJECTIVE: To investigate the effectiveness of the modified Urbaniak operation to treat avascularnecrosis of the femoral head (ANFH). METHODS: A retrospective analysis was made on the clinical data of 38 patients (41hips) with ANFH treated between February 2010 and October 2012 with the modified Urbaniak operation (to add lateralfemoral incision based on femoral greater trochanter incision, to preserve the original fibula flap drilling, decompressionand filling through trochanteric outer cortex, and to select the descending branch of lateral circumflex femoral artery asthe supply vessel)...
January 2016: Chinese Journal of Reparative and Reconstructive Surgery
Dror Lindner, Noam Shohat, Itamar Botser, Gabriel Agar, Benjamin G Domb
Greater trochanteric pain syndrome (GTPS) is a common complaint. Recently, it has become well recognized that tendinopathy and tears of the gluteus medius (GM) are a cause of recalcitrant GTPS. Nevertheless, the clinical syndrome associated with GM tears is not fully characterized. We characterize the clinical history, findings on physical examination, imaging and intraoperative findings associated with symptomatic GM tears. Forty-five patients (47 hips) who underwent GM repair for the diagnosis of tear were evaluated...
October 2015: Journal of Hip Preservation Surgery
John M Redmond, Austin W Chen, Benjamin G Domb
Patients who have lateral hip pain historically have been diagnosed with trochanteric bursitis and treated with nonsteroidal anti-inflammatory medications, corticosteroid injections, and physical therapy. Although this strategy is effective for most patients, a substantial number of patients continue to have pain and functional limitations. Over the past decade, our understanding of disorders occurring in the peritrochanteric space has increased dramatically. Greater trochanteric pain syndrome encompasses trochanteric bursitis, external coxa saltans (ie, snapping hip), and abductor tendinopathy...
April 2016: Journal of the American Academy of Orthopaedic Surgeons
Peter K Sculco, Lionel E Lazaro, Edwin P Su, Craig E Klinger, Jonathan P Dyke, David L Helfet, Dean G Lorich
BACKGROUND: Surgical hip dislocation allows circumferential access to the femoral head and acetabulum and is utilized in the treatment of intra-articular hip disorders. Surgical hip dislocation is currently performed with a trochanteric osteotomy that reliably preserves the femoral head arterial supply; however, trochanteric nonunion or painful hardware requiring removal may occur. In a cadaveric model, using gadolinium-enhanced magnetic resonance imaging (MRI) and gross dissection, we evaluated whether modifications to the posterior approach preserve the femoral head arterial supply after a posterior surgical hip dislocation...
March 16, 2016: Journal of Bone and Joint Surgery. American Volume
Frantz R Lerebours, Randy Cohn, Thomas Youm
Greater trochanteric pain syndrome (GTPS) is a term used to describe disorders of the peritrochanteric region. This constellation of conditions includes greater trochanteric bursitis, gluteus medius (GM) tears, and external coxa saltans or snapping hip syndrome. Tears of the abductor mechanism, more specifically gluteus medius tears, have recently gained a considerable amount of interest in the orthopaedic literature. Abductor tears were first described by Bunker and Kagan in the late 1990s. They used the rotator cuff as an analogous structure to describe the pathological process associated with gluteus medius tears...
March 2016: Bulletin of the Hospital for Joint Diseases
Diane Reid
Greater trochanteric pain syndrome (GTPS) is a common cause of lateral hip pain. Most cases respond to conservative treatments with a few refractory cases requiring surgical intervention. For many years, this condition was believed to be caused by trochanteric bursitis, with treatments targeting the bursitis. More recently gluteal tendinopathy/tears have been proposed as potential causes. Treatments are consequently developing to target these proposed pathologies. At present there is no defined treatment protocol for GTPS...
March 2016: Journal of Orthopaedics
R Coulomb, J Essig, O Mares, G Asencio, P Kouyoumdjian, O May
INTRODUCTION: Various surgical treatments have been proposed for greater trochanteric pain syndrome (GTPS) related to gluteal tendinopathy with partial thickness tears. The clinical results of endoscopic debridement without repair of these gluteal tears are not well known. The objectives of this study were to determine if this procedure leads to: (1) reduction of pain, (2) functional improvement, (3) patient satisfaction (on scale of 0 to 10). HYPOTHESIS: Endoscopic treatment without tendon repair provides short-term pain relief in patients with GTPS due to partial thickness gluteal tears...
May 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
C M Ansari Moein, H J Ten Duis, P L Oey, G A P de Kort, W van der Meulen, Chr van der Werken
PURPOSE: In a level 1 university trauma center, an explorative randomized controlled study was performed to compare soft tissue damage and functional outcome after antegrade femoral nailing through a trochanteric fossa (also known as piriform fossa) entry point to a greater trochanter entry point in patients with a femoral shaft fracture. MATERIALS AND METHODS: Nineteen patients were enrolled and randomly assigned to two nail insertion groups; ten patients were treated with an Unreamed Femoral Nail(®) (UFN, Synthes(®), Solothurn, Switzerland) inserted at the trochanteric fossa and nine patients were treated with an Antegrade Femoral Nail(®) (AFN, Synthes(®), Solothurn, Switzerland) inserted at the tip of the greater trochanter...
December 2011: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Brian T Barlow, John W Boles, Yuo-Yu Lee, Philippe A Ortiz, Geoffrey H Westrich
BACKGROUND: The early short-term outcomes and complications after revision of the recalled Rejuvenate modular neck hip arthroplasty have not been previously reported. This study's purpose is to describe the early outcomes and complications after revision of the Rejuvenate modular femoral neck. METHODS: A retrospective cohort included 92 patients with 92 Rejuvenate modular neck total hip arthroplasty (THA) who underwent revision surgery between July 2011 and April 2014...
April 2016: Journal of Arthroplasty
Iris Sophie Albers, Johannes Zwerver, Ronald Leo Diercks, Janny Hendrika Dekker, Inge Van den Akker-Scheek
BACKGROUND: Lower extremity tendinopathy is a common sports injury, but it can also affect non-athletes. Because tendinopathy is difficult to treat and has negative effects on the ability to work and quality of life, development of preventive interventions is important. The first step in the Van Mechelen prevention model is to determine the extent of the problem. The primary aim of this study was to determine the incidence and prevalence of lower extremity tendinopathy in a Dutch general practice population...
2016: BMC Musculoskeletal Disorders
Mathieu Thaunat, Eric Noël, Laurent Nové-Josserand, Colin G Murphy, Mouhcine Sbiyaa, Bertrand Sonnery-Cottet
Tears in the gluteus medius and minimus tendons have been recognized as an important cause of recalcitrant greater trochanteric pain syndrome. Because of the frequency of partial-thickness undersurface tears, this relatively unknown pathology is often misdiagnosed and left untreated. Surgery is indicated in case of 4 associated conditions: (i) Failure of conservative treatment with duration of symptoms >6 months; (ii) magnetic resonance imaging showing a tendon tear; (iii) positive ultrasound-guided infiltration test; and (iv) the absence of an evolved fatty degeneration or atrophy of the gluteus medius and minimus muscle...
March 2016: Sports Medicine and Arthroscopy Review
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