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Surgical Management of Refractory Trochanteric Bursitis

Department of Orthopedic Surgery, USAF Medical Center, Scott Air Force Base, Illinois

Richard F. Howard, MAJ, MC, USAF

Department of Orthopedic Surgery, USAF Medical Center, Scott Air Force Base, Illinois

We reviewed a single surgeon's experience with the surgical management of refractory trochanteric bursitis in an active population group. The surgical procedure consisted of simple longitudinal release of the iliotibial band over the greater trochanter and excision of the subgluteal bursa. To our knowledge, this is the first series to use this technique. Seven hips in five patients form the basis of the study, making it one of the largest surgical series reported. All patients had no improve ment after a minimum of 1 year of nonoperative man agement consisting of nonsteroidal antiinflammatory medication, iliotibial band stretching, diathermy, ultra sound, and injections of local anesthetics combined with corticosteroids (average, 4.8 injections). Patients had experienced symptoms preoperatively for an av erage of 3.8 years and had noted marked limitation in vocational and recreational activities. The preoperative Harris hip score averaged 51.7. Four of the five pa tients (six hips) were available for evaluation at the time of this study, at an average of 20 months postop eratively. The average Harris hip score was 95.0. All patients were satisfied with the surgical results and had returned to unrestricted vocational and athletic activi ties. The remaining patient was last seen 6 months postoperatively and her Harris hip score had improved from 49 to 84.

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