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Int J Rheum Dis 2021 Jun 10. Epub 2021 Jun 10.

Postgraduation program in Rehabilitation Sciences, UEL/UNOPAR, Paraná, Brazil.

Introduction: There are many studies on the Greater Trochanteric Pain Syndrome (GTPS), however its relationship with radiographic and biomechanics parameters is not established.

Objective: To compare the magnetic resonance images (MRI) of the hip, radiographic parameters of sagittal alignment (pelvic incidence, sacral slope and lumbar lordosis), muscular strength and endurance in women with and without GTPS.

Methods: Forty women, age over 45, IMC <30 Kg/m and sedentary, were recruited and distributed in two groups: GTPS group (GTPSG, n = 20) and Control group (CG, n = 20). Read More

J Orthop Surg Res 2021 May 19;16(1):322. Epub 2021 May 19.

Avanfi Institute and Unit for Ultrasound-guided Surgery, Hospital Beata María Ana, Calle de Donoso Cortes 80, 28015, Madrid, Spain.

Background: Greater trochanteric pain syndrome encompasses a range of causes of lateral hip pain including greater trochanteric bursitis, tendinopathy and tears of the gluteus minimus and medius, and lateral snapping hip (LSH). Surgical options for LSH range from open surgery to endoscopic surgery, including a diamond-shaped cut or a simple transversal release to gluteus maximus tendon release. Resection of an area of proximal iliotibial band (ITB) and step-cut or z-plasty lengthening have not proven superior to transverse release of the ITB. Read More

Orthop J Sports Med 2021 Apr 22;9(4):2325967121998389. Epub 2021 Apr 22.

Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.

Background: Gluteal tendinopathy is commonly reported in the literature, but there is a need for a validated magnetic resonance imaging (MRI)-based scoring system to grade the severity of the tendinopathy.

Purpose: To use intra- and interobserver reliability to validate a new scoring system, the Melbourne Hip MRI (MHIP) score, for assessing the severity of gluteal tendinopathy.

Study Design: Cohort study (diagnosis); Level of evidence, 3. Read More

Clin Sports Med 2021 Apr 5;40(2):311-322. Epub 2021 Feb 5.

USC Epstein Family for Sports Medicine at Keck Medicine of USC, 1520 San Pablo Street, #2000, Los Angeles, CA 90033, USA.

The hip trochanteric bursa, tendinous insertions of the gluteal muscles, and the origin vastus lateralis make up the main structures of the peritrochanteric space. Greater trochanteric pain syndrome (GTPS) refers to pain generated by one or multiple disorders of the peritrochanteric space, such as trochanteric bursitis, gluteus medius and minimus tendinopathy or tear, and disorders of the proximal iliotibial band. Patients with GTPS might present with associated intra-articular hip pathology, which requires further investigation and appropriate management. Read More

Am Fam Physician 2021 01;103(2):81-89

University of New Mexico, Albuquerque, NM, USA.

Adults commonly present to their family physicians with hip pain, and diagnosing the cause is important for prescribing effective therapy. Hip pain is usually located anteriorly, laterally, or posteriorly. Anterior hip pain includes referred pain from intra-abdominal or intrapelvic causes; extra-articular etiologies, such as hip flexor injuries; and intra-articular etiologies. Read More

Arthroscopy 2020 11;36(11):2775-2776

Greater trochanteric pain syndrome includes a spectrum of hip pathology, including trochanteric bursitis, gluteus medius or minimus tendinosis, partial abductor tear, full-thickness tear, and full-thickness tear plus retraction (with or without fatty atrophy). Physical diagnosis includes palpation for tenderness at the greater trochanter and evaluation for strength loss, including observation of gait. Women are significantly more likely to have a tear of the hip abductors than men. Read More

J Chiropr Med 2019 Dec 3;18(4):317-320. Epub 2020 Sep 3.

Clinic Services, Palmer College of Chiropractic Florida, Port Orange, Florida.

Objective: This case study describes conservative management of high hamstring tendinopathy in a master's-age tae kwon do athlete.

Clinical Features: A 53-year-old female tae kwon do athlete of 10 years presented after ceasing activities of performance for over a year owing to chronic pain of insidious onset in the left buttock with radiation to the left hip and posterior thigh. The patient's pain was preventing her from being able to perform regular activities of daily living such as brisk walking or sitting. Read More

Skeletal Radiol 2020 Jul 31;49(7):1155-1158. Epub 2020 Mar 31.

Department of Radiology, St Paul's Hospital, University of British Columbia, Vancouver, BC, V5Z 1M9, Canada.

Injection of steroid and anesthetic into the greater trochanteric bursa is commonly performed for trochanteric bursitis, gluteus medius/minimus tendinopathy, or as a part of a barbotage procedure for gluteus medius or minimus calcific tendonosis. Trochanteric bursal injection is widely performed both with and without image guidance, and is typically viewed as low-difficulty; however optimum needle tip position can be challenging. We discuss a simple dynamic technique to aid the practitioner in optimal needle placement. Read More

Orthop J Sports Med 2020 Jan 24;8(1):2325967119895602. Epub 2020 Jan 24.

Sports Medicine Professionals, Richmond, Australia.

Background: Recalcitrant greater trochanteric pain is increasingly recognized as an indication for surgical intervention. The arthroscopic approach has become rapidly more common than the open alternative.

Hypothesis: Patients undergoing radiofrequency microdebridement (RFMD) as an adjunct to arthroscopic gluteal bursectomy (AGB) and iliotibial band release (ITBR) will experience better functional improvement than AGB and ITBR alone at 1 year. Read More

Arthrosc Tech 2019 Nov 25;8(11):e1379-e1387. Epub 2019 Oct 25.

Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri, U.S.A.

Greater trochanteric pain syndrome can be caused by gluteus medius and minimus tendinopathy/tears and chronic trochanteric bursitis. Specifically, moderate-to-severe abductor tendon tears can cause severe lateral hip pain, limp, and abnormal gait. A variety of open and endoscopic techniques to treat glut abductors hip tears have been described. Read More

N Z Med J 2019 12 13;132(1507):22-32. Epub 2019 Dec 13.

Biostatistics and Computational Biology Unit, University of Otago, Christchurch; Department of Pathology and Biomedical Science, University of Otago, Christchurch.

Aims: To assess whether a single platelet-rich plasma (PRP) injection would reduce pain intensity in chronic greater trochanteric pain syndrome (GTPS).

Methods: Subjects with chronic lateral hip pain were randomised to either a PRP injection (intervention group) or a saline injection (control group) and both groups were prescribed identical eccentric exercise. Brief Pain Inventory (BPI), health professional consultation rate, medication use, Likert scale of progress, Expectation of Improvement Scale were assessed monthly for six months with a final follow-up one year after the intervention. Read More

Skeletal Radiol 2020 May 11;49(5):773-778. Epub 2019 Dec 11.

Ramsay Générale de Santé, Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, 24 Avenue Paul Santy, 69008, Lyon, France.

Purpose: Greater trochanteric pain syndrome (GTPS) is a condition resulting in lateral hip pain, most commonly caused by tendinosis or tear of the gluteus medius and minimus tendons, and greater trochanteric bursitis. Our aim was to assess pelvic parameters and proximal femoral anatomy in patients suffering from surgical-stage GTPS compared with a control group.

Methods: This retrospective, case-control study assessed 43 patients suffering from GTPS, matched according to age, gender, body mass index and level of sport and physical activity to 43 control patients, between 2013 and 2018. Read More

Hip Int 2020 Nov 26;30(6):775-778. Epub 2019 Sep 26.

Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK.

Aim: To evaluate the relationship between radiographic measurements of the hip and sonographic evidence of gluteal tendinopathy and bursitis in patients with lateral hip pain.

Methods And Materials: Patients with lateral hip pain referred for ultrasound of the hip in our institution over a 5-year period were identified. Findings of gluteal tendinopathy and subgluteal or trochanteric bursitis on ultrasound were recorded. Read More

Musculoskelet Sci Pract 2019 10 25;43:83-90. Epub 2019 Jul 25.

School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia. Electronic address:

Background: Understanding of the biopsychosocial characteristics of greater trochanteric pain syndrome (GTPS), a prevalent lower limb tendinopathy, is currently lacking.

Objectives: To quantify differences in participant characteristics between individuals with GTPS and healthy control participants.

Design: Systematic review of original studies with meta-analyses where appropriate. Read More

Arch Orthop Trauma Surg 2020 Feb 26;140(2):145-153. Epub 2019 Jun 26.

Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.

Introduction: Hip abductor tendinopathies are becoming increasingly recognized as clinically relevant disorders. However, knowledge about prevalence of abductor tendinopathies and associated disorders of adjacent hip articular and periarticular structures is limited. In this context, the relative diagnostic value of 1. Read More

Arthrosc Tech 2019 Mar 25;8(3):e331-e334. Epub 2019 Feb 25.

American Hip Institute, Westmont, Illinois, U.S.A.

Greater trochanteric pain syndrome (GTPS) has received increasing attention in recent years. Most patients with GTPS present with trochanteric bursitis and respond to nonoperative treatment. However, a subset of patients may have persistent lateral hip pain or recalcitrant GTPS resulting from an undiagnosed gluteal tendon tear. Read More

Am J Phys Med Rehabil 2019 12;98(12):e149-e150

From the Department of Diagnostic Imaging, National University Health System, Singapore.

Am J Sports Med 2019 04 6;47(5):1130-1137. Epub 2019 Mar 6.

Research Centre for Translational Orthopaedic Research, Sir Charles Gairdner Hospital, Nedlands, Australia.

Background: A previously published trial showed that patients with chronic gluteal tendinopathy achieved greater clinical improvement at 12 weeks when treated with a single platelet-rich plasma (PRP) injection than those treated with a single corticosteroid injection (CSI).

Purpose: This follow-up study was conducted to determine whether there would be a sustained long-term difference in the modified Harris Hip Score (mHHS) at 2 years for a leucocyte-rich PRP (LR-PRP) injection in the treatment of chronic gluteal tendinopathy.

Study Design: Randomized controlled trial; Level of evidence, 1. Read More

Phys Sportsmed 2019 02 3;47(1):15-20. Epub 2018 Oct 3.

a Spectrum Health Orthopedics , Grand Rapids , MI, USA.

Greater trochanteric pain syndrome (GTPS) is a common clinical condition that can affect a wide range of patients. Historically, the condition has been associated with trochanteric bursitis. More recently, however, a growing body of literature has demonstrated gluteus medius tendinopathy and tearing is present in many cases of GTPS. Read More

Trials 2018 Sep 21;19(1):517. Epub 2018 Sep 21.

Northumbria Healthcare NHS Foundation Trust, North Shields, UK.

Background: Greater trochanteric pain syndrome (GTPS) is a painful condition characterised by pain around the greater trochanter usually affecting middle-aged women. The majority of patients will improve with conservative management such as physiotherapy and non-steroidal anti-inflammatory drugs (NSAIDs); however, if this fails then more invasive treatments including corticosteroid injections and surgery may be required. Platelet-rich plasma (PRP) is an autologous blood product, which has a higher concentration of growth factors postulated to provide enhanced healing and anti-inflammatory properties. Read More

Prim Care 2018 Jun;45(2):289-303

Rheumatology Fellowship, San Antonio Uniformed Services Health Education Consortium (SAUSHEC), Uniformed Services University of the Health Sciences, San Antonio Military Medical Center, 3551 Roger Brooke Drive, San Antonio, TX 78234, USA.

Soft tissue musculoskeletal pain disorders are common in the primary care setting. Early recognition and diagnosis of these syndromes minimizes patient pain and disability. This article gives a brief overview of the most common soft tissue musculoskeletal pain syndromes. Read More

BMJ 2018 May 2;361:k1662. Epub 2018 May 2.

School of Health and Rehabilitation Sciences, University of Queensland, QLD 4072, Australia

Objective: To compare the effects of a programme of load management education plus exercise, corticosteroid injection use, and no treatment on pain and global improvement in individuals with gluteal tendinopathy.

Design: Prospective, three arm, single blinded, randomised clinical trial.

Setting: Brisbane and Melbourne, Australia. Read More

Oper Orthop Traumatol 2018 Apr 22;30(2):80-86. Epub 2018 Feb 22.

Klinikum Agnes Karll Laatzen, Klinik für Orthopädie, Unfallchirurgie und Sportmedizin, Klinikum Region Hannover, Hildesheimer Straße 158, 30880, Laatzen, Deutschland.

Objective: Snapping of the iliotibial band over the greater trochanter should be eliminated by reducing tension via lengthening, release, and incision of the iliotibial band.

Indications: Positive clinical examination and painful snapping of the iliotibial band over the greater trochanter, despite extensive conservative treatments, for over 6 months.

Contraindications: Weakness of the abductor muscles with positive Trendelenburg sign. Read More

J Ultrasound Med 2018 Jun 24;37(6):1439-1446. Epub 2017 Nov 24.

Department of Orthopedic Surgery, University Hospital of Rennes, Rennes, France.

Objectives: To assess visibility of the acetabular cup in total hip replacement and to determine the value of direct and indirect signs of iliopsoas impingement syndrome with ultrasound.

Methods: Ultrasound examinations were performed by a single operator in 17 patients with iliopsoas impingement syndrome and 48 control patients. Cup visibility, contact between the cup and psoas tendon, and the presence of indirect signs of iliopsoas impingement syndrome were investigated in all patients. Read More

J Arthroplasty 2017 10 27;32(10):3249-3255. Epub 2017 Apr 27.

Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York.

Background: Most patients who undergo total hip arthroplasty are very satisfied with their outcomes. However, there is a small subset of patients who have persistent pain after surgery. The etiology of pain after total hip arthroplasty varies widely; however, tendon disorders are a major cause of debilitating pain that often go unrecognized. Read More

J Womens Health (Larchmt) 2017 06 6;26(6):633-643. Epub 2017 Mar 6.

1 Department of Rehabilitation, Nutrition, and Sport, College of Science Health and Engineering, School of Allied Health, La Trobe University , Bundoora, Victoria, Australia .

Objective: To evaluate the diagnostic accuracy of 10 clinical tests that can be used in the diagnosis of greater trochanteric pain syndrome (GTPS) in women, and to compare these clinical tests to magnetic resonance imaging (MRI) findings.

Materials And Methods: Twenty-eight participants with GTPS (49.5 ± 22. Read More

Acta Ortop Bras 2016 Jul-Aug;24(4):208-212

. Irmandade da Santa Casa de Misericórdia de São Paulo, Department of Orthopedics and Traumatology, São Paulo, SP, Brazil.

Objective: To compare the efficacy of platelet rich plasma (PRP) against corticosteroid on the treatment of trochanteric pain syndrome

Methods: From July 2011 to November 2012, eighteen patients (20 hips) with trochanter pain syndrome were randomized in two groups and treated with platelet rich plasma or triamcinolone infiltration guided by ultrasound. Pain and function were evaluated prior to the intervention and after 10, 30 and 60 days, through the Facial Expressions Scale for Pain and the Western Ontario McMaster and Harris Hip Score questionnaires. Inter-group analysis was performed by Student t-test and intragroup analysis by ANOVA, followed by Bonferroni post hoc test. Read More