Abstract
Lateral sided hip pain frequently presents to the orthopaedic clinic. The most frequent cause of this pain is trochanteric bursitis. This usually improves with conservative treatment. In a few cases it doesn’t settle and warrants further investigation and treatment. Between July 2006 and February 2008, 28 patients underwent MRI scanning for such pain, 16 were found to have a tear of their abductors. All 16 underwent surgical repair using multiple soft tissue anchors inserted into the greater trochanter of the hip to reattach the abductors.
There were 15 females and 1 male. They had a mean age of 62. All patients completed a self-administered questionnaire pre-operatively and 1 year postoperatively. Data collected included: A visual analogue score for hip pain, Charnley modification of the Merle D’Aubigne and Postel hip score, Oxford hip score, Kuhfuss score of Trendelenburg and SF36 scores.
Of the 16 patients who underwent surgery 5 had a failure of surgical treatment. There were 4 re ruptures, 3 of which were revised and 1 deep infection which required debridement. In the remaining 11 patients there were statistically significant (p< 0.05) improvements in hip symptoms. The mean change in visual analogue score was 5 out of 10. The mean change of Oxford hip score was 20.5. The mean improvement in SF-36 PCS was 8.5 and MCS 13.7. 6 patients who had a Trendelenberg gait pre-surgery had normal gait 1 year following surgery.
We conclude that hip abductor mechanism tear is a frequent cause of recalcitrant trochanteric pain that should be further investigated with MRI scanning. Surgical repair is a successful operation for reduction of pain and improvement of function. However there is a relatively high failure rate.
The abstracts were prepared by Mr D J Bracey, Editorial Secretary. Correspondence should be addressed to him at Royal Cornwall Hospital, Treliske, Cornwall TR1 3LJ, England.
