International Orthopaedics January 2018, Volume 42, Issue 1, pp 77–85

Surgery for greater trochanteric pain syndrome after total hip replacement confers a poor outcome

Eve Robertson-Waters, James R. Berstock, Michael R. Whitehouse, Ashley W. Blom
Hip

Purpose

Surgery for greater trochanteric pain syndrome (GTPS) may be indicated for cases refractory to conservative measures. We aim to evaluate patient reported outcomes and adverse events following surgery.

Methods

Postal questionnaires were used to evaluate a consecutive series of 61 bursectomy and gluteal fascia transposition (GFT) procedures. Study outcomes were Oxford hip score, satisfaction score, visual analogue score, pain lying on the affected side, and the duration of pain relief after surgery.

Results

We received responses regarding 52 procedures at a median of 34 months follow-up; 40% of cases of GTPS occurred following THA. We observed a bimodal distribution of satisfaction scores. The early post-operative complication rate was 13%; an additional seven cases (12%) required further surgery at a later date. Idiopathic GTPS had significantly better post-operative satisfaction than GTPS following THA, 87.5 vs. 37.5 (p = 0.006); Oxford hip scores, 35 vs. 15 (p = 0.015); and visual analogue scores, 20 vs. 73 (p = 0.005).

Conclusion

We observed overall poor outcomes, significant complications and concerning reoperation rates. Cases with previous joint replacement were associated with the worst outcomes.


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