Management of the greater trochanteric pain syndrome: a systematic review

Abstract

Greater trochanteric pain syndrome (GTPS) is a debilitating condition characterized by lateral hip pain located at or around the greater trochanter. We performed a comprehensive search of Pubmed, Medline, Ovid, Google Scholar and Embase databases, from inception of the database to 20th of June 2011, using a variety of keywords. We identified 52 relevant abstracts of articles published in peer-reviewed journals. Fourteen studies reporting the outcomes of patients undergoing conservative and surgical management of GTPS were selected. Significant pain relief and improved outcomes were observed after conservative and surgical management of GTPS. The modified Coleman methodology score averaged 44.7 (range from 14 to 82), evidencing an overall low-to-moderate quality of the studies. Repetitive low-energy radial shock wave therapy and home training approach provide beneficial effect over months, with almost 80% success rate at 15 months. Poor available data extracted from small studies do not allow definitive conclusions to be drawn on the best treatment for GTPS. Further multi-centre prospective studies are necessary to confirm the general validity of the findings reported. Future research and trials should focus on the application and effectiveness of the various conservative modalities for management of GTPS. The effectiveness of the various treatment modalities needs to be tested in carefully conducted randomized controlled trials.