Endoscopic Bursectomy and Iliotibial Tract Release as a Treatment for Refractory Greater Trochanteric Pain Syndrome: A New Endoscopic Approach With Early Results

Govaert, L. H. M.; Dijk, C. Niek van; Zeegers, Adelgunde V.C.M.; Albers, G. H. R.

doi:10.1016/j.eats.2012.06.001

Cited by 39 publications

(18 citation statements)

References 9 publications

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“…This surgery is performed either as an open or an arthroscopic procedure, and the technique of ITB release varies from proximal Z-plasty to proximal longitudinal release, T-section and distal Z-plasty [73,[87][88][89][90][91]. There are no data on the comparative efficacy of these procedures, and all studies (case series) have reported good to excellent shortto medium-term outcomes.…”

Section: Surgical Interventionsmentioning

confidence: 96%

Gluteal Tendinopathy: A Review of Mechanisms, Assessment and Management

Grimaldi¹,

et al. 2015

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Tendinopathy of the gluteus medius and gluteus minimus tendons is now recognized as a primary local source of lateral hip pain. The condition mostly occurs in mid-life both in athletes and in subjects who do not regularly exercise. Females are afflicted more than males. This condition interferes with sleep (side lying) and common weight-bearing tasks, which makes it a debilitating musculoskeletal condition with a significant impact. Mechanical loading drives the biological processes within a tendon and determines its structural form and load-bearing capacity. The combination of excessive compression and high tensile loads within tendons are thought to be most damaging. The available evidence suggests that joint position (particularly excessive hip adduction), together with muscle and bone elements, are key factors in gluteal tendinopathy. These factors provide a basis for a clinical reasoning process in the assessment and management of a patient presenting with localized lateral hip pain from gluteal tendinopathy. Currently, there is a lack of consensus as to which clinical examination tests provide best diagnostic utility. On the basis of the few diagnostic utility studies and the current understanding of the pathomechanics of gluteal tendinopathy, we propose that a battery of clinical tests utilizing a combination of provocative compressive and tensile loads is currently best practice in its assessment. Management of this condition commonly involves corticosteroid injection, exercise or shock wave therapy, with surgery reserved for recalcitrant cases. There is a dearth of evidence for any treatments, so the approach we recommend involves managing the load on the tendons through exercise and education on the underlying pathomechanics.

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Section: Surgical Interventionsmentioning

confidence: 96%

Gluteal Tendinopathy: A Review of Mechanisms, Assessment and Management

Grimaldi¹,

et al. 2015

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“…This in turn causes local inflammation, degeneration of the tendons and increased tension of the ITB. 23 Approximately two thirds of individuals with GTPS have coexisting hip joint osteoarthritis or low back pain. 24 Having a higher than normal body mass index is also a likely contributing factor to GTPS.…”

mentioning

confidence: 99%

“…12,13,27 The techniques of ITB lengthening varied between the studies, and all were proximal ITB techniques except one, which was distal. 13 Z-lengthening was undertaken in two studies 27,65 ; cross-incision was used in one study 23 and longitudinal release in one study. 68 Trochanteric bursectomy was performed in all the proximal procedures.…”

mentioning

confidence: 99%

The management of greater trochanteric pain syndrome: A systematic literature review

Reid

2016

Journal of Orthopaedics

103

102

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“…Baker et al, in a prospective study of 25 patients who underwent arthroscopic bursectomy and were assessed at a mean follow-up of 26 months, showed significant improvement in Visual Analog Score (VAS; 7.2-3.1), Harris Hip Scores (HHS; 51-77), and short-form 36 scores from the preoperative status scores [22]. Variations on the endoscopic bursectomy have been described, including an ITB release either preceding [23] or subsequent to the bursectomy [25], with favorable results. Similarly, successful treatment of GTB secondary to gluteus medius and minimus calcific tendonitis has been described by Kandemir et al [26].…”

Section: Greater Trochanteric Bursitismentioning

confidence: 99%