Endoscopic treatment of the Retro-trochanteric Pain Syndrome. A quality study with medium-term follow-up
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https://hdl.handle.net/10037/13503Dato
2018-06-03Type
Master thesisMastergradsoppgave
Forfatter
Mikkelsen, EirikSammendrag
Introduction.
Retro-trochanteric pain syndrome (RTPS) is a condition characterized by pain and tenderness
in the buttock region. Normally sciatica originates from pathology in the spine. In RTPS the
pathology resulting in sciatica is localized in the buttock region. First line treatment for RTPS
is physiotherapy. This study evaluate treatment of RTPS by endoscopic bursectomy and
microtenotomy of the short rotator affecting the sciatic nerve.
Patients and methods.
11 patients (12 hips) operated with endoscopic bursectomy and microtenotomy of a short
rotator for treatment of RTPS were included in the study. The average age of the patients (1
male and 10 female) were 57.2 years and the mean duration of symptoms were 6.7 years. All
patients had failed preoperative attempts of conservative treatment such as physiotherapy,
NSAIDs and local steroid injections. The short-term follow-up was 3 months and the mean
medium-term follow-up was 5 years. We evaluated the level of pain (using the visual
analogue scale, VAS), function and clinical examination preoperatively, at 3 months and at 5
years. We also evaluated level of satisfaction and postoperative time without symptoms.
Standard radiographs of the pelvis and hips and MRI of the lumbar spine, pelvis and hips
were done preoperative and at medium-term follow-up.
Results.
Pain significantly decreased from a mean VAS of 8.3 (SD 0.99) to 2.4 (SD 1.7), p-value =
0.002 at short-term and 5.1 (SD 2.6), p-value = 0.006 at medium-term follow-up. The ability
to sit and usage of pain medication had a significant improvement. Overall satisfaction was
high. Between surgery and final follow-up five patients developed OA in the hip(s).
Conclusion.
Endoscopic bursectomy and microtenotomy of the small rotators in the hip are a valuable
treatment method for patients with RTPS, the patients had significantly reduced pain and
improved function five years after operation.
Forlag
UiT Norges arktiske universitetUiT The Arctic University of Norway
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