Abstract
Greater trochanteric pain syndrome (GTPS) is a common condition resulting in posterolateral hip pain typically in perimenopausal women. Gluteal tendinopathy is the underlying pathology and contributes to health care cost burden as a poorly managed tendon disorder. There is no established effective treatment for gluteal tendon pathology in GTPS. This article describes clinical, imaging and life style improvements after percutaneous tendon repair using autologous platelet rich plasma tenotomy under ultrasound imaging guidance in a case of GTPS. The improvements observed in this patient add to the call for urgent medical and economical need for more research on percutaneous tendon repair.
Highlights
Greater trochanteric pain syndrome (GTPS) is a common cause of posterolateral hip pain typically seen in peri and post menopausal women
GTPS is widely referred to as greater trochanteric ‘bursitis’, there is no inflammation of the greater trochanteric bursa on histological evaluation of surgical specimens[6]
The natural history of GTPS is favourable in most cases and responds to physical therapy, weight loss, non-steroidal anti-inflammatory drugs and behaviour modification[1]
Summary
Greater trochanteric pain syndrome (GTPS) is a common cause of posterolateral hip pain typically seen in peri and post menopausal women. Evaluation using imaging and histology techniques revealed degenerative tendinosis with tears of the gluteal tendons[2,3,4]. The primary underlying pathology of GTPS is a gluteal tendinopathy with or without tears of the tendon[5]. GTPS is widely referred to as greater trochanteric ‘bursitis’, there is no inflammation of the greater trochanteric bursa on histological evaluation of surgical specimens[6]. Corticosteroid injection into the bursa and surgical repair of any torn gluteal tendons are the current common treatment options. Corticosteroid injections carry the risk of a dampening effect and progressive worsening of tendon pathology[8]. A pioneering percutaneous treatment for all tendoligamentous and cartilage tears using autologous platelet rich plasma (PRP) tenotomy under high resolution imaging control was routine clinical management in the author’s practice. This report is the 1-year follow up on the clinical outcome and imaging appearance of this patient
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