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Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_I | Pages 25 - 25
1 Jan 2011
Walsh N Walsh M Walton J Millar N
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Lateral hip pain is a common problem in middle-aged females. After investigation, a group of patients remain who are given the diagnosis of ‘trochanteric bursitis’. Treatment to date has included physiotherapy, non-steroidal anti inflammatory medication and judicious use of a combined corticosteroid and local anaesthetic preparation injected into the bursa with or without imaging control. Some surgical procedures have been described. The aims of this study are to document and describe our experience with 88 patients and to raise awareness of the condition as a common cause of lateral hip pain which is amenable to surgical repair.

This study has the approval of the Western Sydney area health service. Between 2000 and 2008, 161 patients were referred to the senior author for management of lateral hip pain. 121 patients underwent surgery to repair a gluteal tendon detachment. 32 patients were excluded from the study due to concurrent or previous surgery to the area. A surgical audit was performed on the remaining 88 patients.

Assessment was performed using the Merle d’Aubigne and Postel scoring system. The average duration of symptoms was 6 – 144 months. At 6 months, 88% patients had minimal or no pain. There were also significant improvements in range of motion and ability to walk. The most significant complication was deep vein thrombosis (6%).

Based on our experience, any patient who does not respond to treatment for trochanteric bursitis should be investigated for a gluteal tendon tear. Those with a positive MRI scan of the trochanteric region can be offered surgery for gluteal tendon repair.


Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_I | Pages 138 - 138
1 Mar 2006
Walton M Walton J Honorez L Harding V Wallace W
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Introduction The Constant-Murley Score is the functional score currently recommended by the British Shoulder and Elbow Society and by the European Society for Surgery of the Shoulder and Elbow. Normal Values for shoulder assessment are imperative for the diagnosis of pathology and measurement of treatment outcome. Normal values for the UK are currently not known. Several techniques have been described for the assessment for strength and measurement of this paraemeter differs between published series.

Patients and method 122 patients over 50 (62 male) attended a GP surgery for a Constant Score measurement. Constant Score was assessed using three techniques for strength measurement: maximum strength with myometer (Mmax), mean strength with myometer (Mmean) and maximum strength with fixed spring balance (FSB).

Results Maximum strength values measured by myometer or fixed spring balance were very similar with a mean difference of 0.5 (less than the calibration of a spring balance). Mean strength measurements were consistently lower than maximum strength measurements with a mean difference of 3 points. Age and sex both significantly affected Constant Score (P< 0.001, P< 0.001). Constant Score falls by 0.4 points per year over 50. Males have a score 8 points greater than females.

Conclusions Constant Score decreases predictably with age in the UK. Methods of strength assessment are not the same. A uniform method of shoulder strength assessment or correction for method is required to allow meaningful comparisons between series.