Lateral Trochanteric Pain Following Primary Total Hip Arthroplasty: Incidence and Success of Nonoperative Treatment

Skibicki, Hope E.; Brustein, Jason A.; Orozco, Fabio; Ponzio, Danielle Y.; Post, Zachary D.; Ong, Alvin

doi:10.1016/j.arth.2020.07.043

Cited by 9 publications

(7 citation statements)

References 25 publications

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“…TP following THA is a common complication with an incidence reported between 1% and 17% 3,4. In this case, subcutaneous protrusion of the prosthetic stem due to a posttraumatic defect of both the greater trochanter and of the abductors caused the symptoms (Fig.…”

Section: Discussionmentioning

confidence: 83%

“…3,4 Studies regarding the association of TP with the surgical approach remain inconsistent and may be obsolete. 4 The etiology of TP is associated with trochanteric bursitis, soft tissue defects over the GT, bone substance defects over the shoulder of the underlying stem, and enlarged femoral offset. 3,5 Regarding the management of the abductors there are different surgical techniques described with varying complexity.…”

mentioning

confidence: 99%

“…Symptoms may be similar to end-stage hip osteoarthritis and limit particularly sitting or lying on the affected side 2. The incidence of TP after THA is reported to be between 1% and up to 17% 3,4. Studies regarding the association of TP with the surgical approach remain inconsistent and may be obsolete 4.…”

mentioning

confidence: 99%

“…The incidence of TP after THA is reported to be between 1% and up to 17% 3,4. Studies regarding the association of TP with the surgical approach remain inconsistent and may be obsolete 4. The etiology of TP is associated with trochanteric bursitis, soft tissue defects over the GT, bone substance defects over the shoulder of the underlying stem, and enlarged femoral offset 3,5.…”

mentioning

confidence: 99%

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A Cutaneous Transposition Inversion Flap to Treat Symptomatic Subcutaneous Trochanteric or Soft Tissue Defects After Hip Arthroplasty: A Technical Note

Liebe¹,

Lehnen

Jandali³

et al. 2022

Techniques in Orthopaedics

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Introduction: Up to 17% of patients with total hip arthroplasty (THA) suffer from greater trochanteric or lateral trochanteric pain. Subcutaneous soft tissue or trochanteric bone substance defects with protrusion of the underlying stem may be challenging causes.Surgical Technique: We present the surgical technique of a deepithelialized cutaneous transposition inversion flap to cover subcutaneous implant protrusion, performed successfully in a patient with posttraumatic trochanteric defect following THA after failed internal fixation for a trochanteric fracture. Results and Conclusion:The patient had no more trochanteric pain, allowing her to walk, sit, and sleep without pain. The THA protrusion was no longer palpable under the uneventfully healed skin. The technique described is relatively simple and may help improve therapy in patients with symptomatic trochanteric bone or soft tissue defects.

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Section: Discussionmentioning

confidence: 83%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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A Cutaneous Transposition Inversion Flap to Treat Symptomatic Subcutaneous Trochanteric or Soft Tissue Defects After Hip Arthroplasty: A Technical Note

Liebe¹,

Lehnen

Jandali³

et al. 2022

Techniques in Orthopaedics

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“…Most of this pain can be treated by non-surgical means. 24 Numerous studies have shown that the surgical approach may have an impact on the incidence of this condition, 22,25 while Worlicek et al found that patients with absolute deviations in combined biomechanical recovery of leg length, femoral and acetabular offset of more than 5 mm frequently experienced symptoms of trochanteric pain syndrome. 15 In the present study, although the increased FO group had a higher incidence of pain in the current investigation (24.0%), there was no statistically significant difference between the three groups (p = 0.299), suggesting that a greater sample size could be necessary to obtain meaningful results.…”

Section: Clinical Efficacymentioning

confidence: 99%

The Role of Global Femoral Offset in Total Hip Arthroplasty with High Hip Center Technique

Yang

Wang

et al. 2023

Orthopaedic Surgery

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ObjectiveThe high hip center (HHC) technique has been proposed for the treatment of patients with developmental dysplaisa of the hip (DDH) who have an acetabular bone defect. However, the importance of global femoral offset (FO) in the application of this technique has not been sufficiently appreciated. Our goals were to confirm that the HHC technique is feasible in the treatment of patients with DDH and to assess the function of global FO in this procedure.MethodsWe retrospectively analyzed 73 patients who underwent total hip arthroplasty using high hip center technique for unilateral DDH at our hospital between January 2014 and June 2019. According to global FO, the patients were split into three groups: increased FO group (increment greater than 5 mm), restored FO group (restoration within 5 mm) and decreased FO group (reduction greater than 5 mm). Patients' medical records and plain radiographs were reviewed. One‐way ANOVA was used to compare radiographic outcomes and Harris hip score (HHS). Paired t‐test was used to assess preoperative and postoperative HHS and leg length discrepancy. Trochanteric pain syndrome, Trendelenburg sign and postoperative limp was evaluated with Fisher's exact test.ResultsThe average follow‐up time was 7.5 ± 1.4 years. The patients' HHS and leg length discrepancy were significantly improved (p < 0.05). In terms of vertical acetabular height, abductor arm, postoperative leg length difference, and acetabular cup inclination, there was no statistically significant difference between the three groups. At the last follow‐up, HHS was significantly higher in the restored FO group than in the decreased FO and increased FO groups. Trochanteric pain syndrome occurred in 15.0% and Trendelenburg sign and postoperative limp in 8.2% of all patients, respectively. Trochanteric pain syndrome, Trendelenburg sign and postoperative limp did not differ significantly across the three groups. One patient in increased FO group underwent revision for dislocation 6 years after surgery.ConclusionThe HHC technique is an alternative technique for total hip arthroplasty in patients with acetabular bone abnormalities, according to the results of the mid‐term follow‐up. Also, controlling the correction of the global femoral offset to within 5 mm may lead to better clinical outcomes.

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Risk Factors for Trochanteric Bursitis Following Total Hip Arthroplasty: A Radiographic Analysis

White,

Lach,

Schmitt

et al. 2024

The Journal of Arthroplasty

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Lateral Trochanteric Pain Following Primary Total Hip Arthroplasty: Incidence and Success of Nonoperative Treatment

Cited by 9 publications

References 25 publications

A Cutaneous Transposition Inversion Flap to Treat Symptomatic Subcutaneous Trochanteric or Soft Tissue Defects After Hip Arthroplasty: A Technical Note

A Cutaneous Transposition Inversion Flap to Treat Symptomatic Subcutaneous Trochanteric or Soft Tissue Defects After Hip Arthroplasty: A Technical Note

The Role of Global Femoral Offset in Total Hip Arthroplasty with High Hip Center Technique

Risk Factors for Trochanteric Bursitis Following Total Hip Arthroplasty: A Radiographic Analysis

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