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Arthroscopy 2021 07;37(7):2137-2139

The optimal classification system in arthroscopic and related surgery research and clinical practice should be clinically relevant, descriptive, reproducible, simple, inexpensive, safe, and widely applicable. For the hip, classification systems that characterize intra-articular disorders like femoroacetabular impingement (FAI) syndrome, dysplasia, labral tears, and articular cartilage disease predominate the literature. Recently, awareness of peritrochanteric and other extra-articular disorders has increasingly led to greater recognition, diagnosis, and treatment of what has been historically known as "just bursitis". Read More

SAGE Open Med 2021 3;9:20503121211022582. Epub 2021 Jun 3.

Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.

Greater trochanteric pain syndrome is a common cause of lateral hip pain, encompassing a spectrum of disorders, including trochanteric bursitis, abductor tendon pathology, and external coxa saltans. Greater trochanteric pain syndrome is primarily a clinical diagnosis, and careful clinical examination is essential for accurate diagnosis and treatment. A thorough history and physical exam may be used to help differentiate greater trochanteric pain syndrome from other common causes of hip pain, including osteoarthritis, femoroacetabular impingement, and lumbar stenosis. Read More

Jt Dis Relat Surg 2021 11;32(2):536-541. Epub 2021 Jun 11.

Division of Paediatric Orthopaedic Surgery, Children's Hospital Zagreb, Ulica Vjekoslava Klaica 16; 10000 Zagreb, Croatia.

Tuberculous trochanteric bursitis (TTB) is an extremely rare form of extrapulmonary tuberculosis. Due to a low clinical suspicion and poor collaboration among medical professionals, the diagnosis of TTB can be often delayed. In this report, we describe a case of neglected TTB in an adolescent girl that initially presented with right thigh swelling and fluctuance. Read More

Int J Rheum Dis 2021 Jul 10;24(7):941-947. 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

Acta Biomed 2021 04 30;92(S1):e2021043. Epub 2021 Apr 30.

Rizzoli-Sicilia Department, IRCCS Istituto Ortopedico Rizzoli.

Background: The giant haemorrhagic bursitis of the hip joint is a rare clinical condition that requires evidence-based guidelines for adequate diagnosis and management. Usually, this pathology requires conservative treatment; however, when abnormal size or clinical symptoms of compression of the surrounding noble structures are reported, an accurate differential diagnosis is required, in order to exclude other malignant conditions that can be included into differential diagnosis, and a surgical approach should be considered. The purpose of this work is to provide an appropriate description of the diagnostic and therapeutic path, providing an accurate analysis of the possible differential diagnoses. 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

Hip Int 2021 Feb 18:1120700021991452. Epub 2021 Feb 18.

Department of Orthopaedic surgery and Traumatology, Hospital Clínico San Carlos, Madrid, Spain.

Introduction: Osteotomy of the greater trochanter is a commonly used procedure in complex revision hip arthroplasty in order to achieve a wide exposure to the femoral stem and acetabular components. There is no clinical evidence in favour of a specific fixation method. The aim of this study was to compare cable-plate with figure-of-eight cerclage wire fixation in patients requiring a trochanteric "slide" osteotomy. Read More

Mediterr J Rheumatol 2020 Dec 28;31(4):389-392. Epub 2020 Dec 28.

Barking Havering and Redbridge University Hospitals NHS Trust, Rheumatology and Rehabilitation, King George Hospital, Ilford, United Kingdom.

Introduction: The item 'hip pain' is widely used in questionnaires related to Spondyloarthritis and/or Ankylosing spondylitis (AS), either in clinics with patients being physically present or remotely, as the hip joint is known to affect AS in particular. Patients in clinics often claim to have hip pain. However, by stating "hip" they are referring to variable structures located in the hip region not necessarily related to hip joint itself. 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

Hip Int 2021 Jan 11:1120700020986136. Epub 2021 Jan 11.

Clinical Research Unit, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.

Background: Trochanteric bursitis or greater trochanteric pain syndrome is a common disorder and frequent cause of lateral hip pain. It can lead to severe functional impairment with increase morbidity and poor quality of life.The purpose of the current study was to identify and evaluate relationship between health-related factors, as prognostic indicators, and clinical outcomes. Read More

Knee Surg Sports Traumatol Arthrosc 2021 Aug 19;29(8):2408-2416. Epub 2020 Dec 19.

Addenbrooke's - Cambridge University Hospitals NHS Foundation Trust, Hills Road, Box 37, Cambridge, CB2 0QQ, UK.

Purpose: Recent advances in diagnostic imaging techniques and soft tissue endoscopy now allow for precise diagnosis and management of extra-articular hip pathology. The aim of this scoping review is to present an evidence-based update of the relevant literature focussing only on the pathoanatomy, clinical assessment and the diagnosis of pathology in the peritrochanteric space.

Methods: A literature search was performed on PubMed to include articles which reported on the anatomy and diagnosis of greater trochanteric pain syndrome, trochanteric bursitis, gluteus medius tears and external snapping hip syndrome. Read More

Knee Surg Sports Traumatol Arthrosc 2021 Aug 21;29(8):2417-2423. Epub 2020 Nov 21.

Addenbrooke's Hospital, Cambridge, UK.

Purpose: Greater trochanter pain syndrome (GTPS) or lateral hip pain terms include external snapping hip, trochanteric bursitis and gluteus medius or minimus pathology. The aim of this review is to update the most recent knowledge about non-surgical management of peritrochanteric disorders.

Methods: A literature review was performed including articles most relevant in the last years that were focused in non-surgical treatment of peritrochanteric disorders. 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

World J Orthop 2020 Oct 18;11(10):473-474. Epub 2020 Oct 18.

Department of Trauma and Orthopaedics, University Hospital Limerick, Limerick V94 F858, Ireland.

Trochanteric bursitis is one of the most common causes of lateral hip pain in adults. The prevalence of unilateral trochanteric bursitis is 15.0% in women and 8. Read More

Orthop Traumatol Surg Res 2020 Oct 31:102709. Epub 2020 Oct 31.

Orthopedic Surgery, Department of Surgery, Hôpital Sacré-Cœur de Montréal, 5400 boulevard Gouin O., H4J 1C5 Montréal, Québec, Canada.

Background: Greater trochanteric pain (GTP) after total hip replacement is a common cause of residual lateral hip pain, regardless of the approach used. The goal of our study was to evaluate GTP after a direct anterior approach (DAA) compared to a posterior approach (PA) as well as the clinical outcomes of both approaches and answer the following: 1) What is the incidence of trochanteric pain after primary THA with two different surgical approaches? 2) What is the functional outcome of patients with GTP? 3) What proportion of patients with GTP resort to peritrochanteric injections?

Hypothesis: Our hypothesis is that GTP is present with both approaches but satisfaction is lower with the PA.

Patients And Methods: A secondary analysis of a previously published clinical trial with 55 total hip arthroplasty patients randomized in one of two surgical approaches: 27 patients underwent the anterior modified Hueter approach, while the other group of 28 patients were operated using the posterior approach. Read More

Knee Surg Sports Traumatol Arthrosc 2021 Aug 12;29(8):2401-2407. Epub 2020 Oct 12.

Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 1200 Main St. W. HSC 4E15, Hamilton, ON, L8N 3Z5, Canada.

Purpose: Greater trochanteric pain syndrome (GTPS) refers to the constellation of signs and symptoms related to pain in the trochanteric region and has recently replaced the previously ubiquitous term of 'greater trochanteric bursitis'. GTPS is common, particularly in women 50-79 years of age, and the understanding and management of GTPS have expanded considerably in recent years to include management with arthroscopic and endoscopic techniques in recalcitrant cases. The purpose of this scoping literature review was to summarize the current evidence on arthroscopic management of GTPS including sources of evidence, key concepts, and gaps in the literature. Read More

J Arthroplasty 2021 07 17;36(7S):S358-S362. Epub 2020 Sep 17.

The Bone & Joint Center, Magee Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Arthritis and Arthroplasty Design Lab, Department of Orthopaedic Surgery, University of Pittsburgh; Department of Bioengineering, and Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA.

Background: Diagnosis of adverse local tissue reaction (ALTR) in metal-on-polyethylene (MoP) total hip arthroplasty (THA) secondary to head-neck taper corrosion is challenging. The purpose of this study is to compare differences between asymptomatic and symptomatic ALTR in an observational cohort, including presentation, metal ion differences, and metal artifact reduction sequence (MARS) magnetic resonance imaging (MRI) findings.

Methods: We performed a retrospective review of an observational cohort of 492 MoP THA patients at increased risk of developing ALTR. 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

J Arthroplasty 2021 01 22;36(1):193-199. Epub 2020 Jul 22.

Rothman Orthopaedic Institute, Egg Harbor Township, NJ.

Background: Our study aimed at quantifying the overall incidence of lateral trochanteric pain (LTP) following total hip arthroplasty (THA) and risk based on surgical approach. The success of conservative treatment and potential risk factors for failure of conservative treatment were evaluated.

Methods: This is a retrospective review of patients who underwent primary THA between 2010 and 2019 and had a postoperative diagnosis of ipsilateral LTP. Read More

J Bone Joint Surg Am 2020 08;102(15):e91

Department of Orthopaedic Surgery, Ohio State University Wexner Medical Center, Columbus, Ohio.

Transpl Infect Dis 2020 Dec 24;22(6):e13392. Epub 2020 Jul 24.

College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.

Mycoplasma hominis can be isolated frequently from the genitourinary tract of some healthy individuals. On rare occasions, it acts as a pathogen in immunocompromised patients such as transplant recipients. Here, we describe the case of a 39-year-old man with end-stage kidney disease secondary to diabetic nephropathy who received a simultaneous pancreas-kidney transplant. Read More

Bone Joint J 2020 Jun;102-B(6):693-698

Norfolk and Norwich University Hospital, Norwich, UK.

Aims: Despite few good-quality studies on the subject, total hip arthroplasty (THA) is increasingly being performed for displaced intracapsular fractures of the neck of femur. We compared outcomes of all patients with displacement of these fractures treated surgically over a ten-year period in one institution.

Methods: A total of 2,721 patients with intracapsular fractures of the femoral neck treated with either a cemented hemiarthroplasty or a THA at a single centre were retrospectively reviewed. Read More

J Am Osteopath Assoc 2020 Jun;120(6):421-424

Hip pain in adults is a common complaint. Secondary processes can often mask underlying conditions, prolonging the course to diagnosis and definitive treatment. In this case, a 74-year-old man presented to an outpatient clinic after 6 weeks of right hip pain that began upon initiation of a rehabilitation program following coronary artery bypass graft surgery. Read More

Ultrasound Med Biol 2020 07 5;46(7):1584-1598. Epub 2020 May 5.

Center for General Practice at Aalborg University, Aalborg, Denmark.

Ultrasound (US) assists in the determination of the pathology underlying greater trochanteric pain syndrome (GTPS); however, there exists no consensus regarding the US criteria used to define these pathologies. We aim to explore these US definitions and their associated prevalence. "Trochanteric bursitis" was defined in 10 studies (13 included studies) and was heterogeneously described. Read More

Skeletal Radiol 2020 Oct 2;49(10):1547-1554. Epub 2020 May 2.

Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA, USA.

Object: The purpose of this study was to assess whether fluoroscopically guided corticosteroid injections into the extrabursal tissues, trochanteric (subgluteus maximus) bursa, or subgluteus medius bursa provide better immediate and short-term pain relief.

Materials And Methods: All fluoroscopically guided corticosteroid injections performed over a 67-month period for greater trochanteric pain syndrome were retrospectively reviewed. Procedural images were reviewed by two musculoskeletal radiologists to determine the dominant injection site based on final needle positioning and contrast spread pattern, with discrepancies resolved by consensus. 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

Pain Med 2020 11;21(11):3243-3244

Department of Orthopaedic Surgery & Rehabilitation Medicine, SUNY Downstate Medical Center, Brooklyn, New York, USA.