Purpose
To assess the effects of surgery for lesser trochanteric–ischial impingement (LTI)
on low back pain.
Methods
The records of patients with LTI who underwent endoscopic partial resection of the
lesser trochanter (LT) between May of 2017 and February of 2019 were reviewed. Inclusion
criteria were the presence of low back pain in association with hip pain, diagnosis
of LTI, and partial resection of the LT to treat LTI. Exclusion criteria were less
than 12 months of postoperative follow-up and hip or spine surgery after the LTI surgery.
Patients were assessed before surgery and at the most recent follow-up with the modified
Harris Hip Score and Oswestry Disability Index for lumbar spine.
Results
Thirty patients (31 hips) met the inclusion criteria. Four patients were lost to follow-up.
Two patients with borderline dysplasia and grade 1 and 2 osteoarthritis underwent
total hip arthroplasty after the partial resection of the LT. The results are presented
considering the remaining 24 patients (25 hips). The average age at surgery was 51
years (range 32-65 years). The mean follow-up after the surgery for LTI was 19 months
(range 12-35 months). The mean ± SD ODI improved from 48% ± 15 before the LTI surgery
to 21% ± 22 (P < .001) at the most recent follow-up. Improvement in the Oswestry Disability Index
above the minimal clinical important difference was observed in 16 patients (67%)
following the LTI surgery. The mean ± SD modified Harris Hip Score improved from 55.8
± 14 before LTI surgery to 81.3 ± 14.3 (P < .001).
Conclusions
Decrease in low back pain above the minimal clinically important difference is observed
in 2 of 3 patients after partial resection of the LT.
Level of Evidence
Level IV, therapeutic case series.
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Article info
Publication history
Published online: January 15, 2021
Accepted:
January 3,
2021
Received:
August 6,
2020
Footnotes
See commentary on page 1510
The authors report the following potential conflicts of interest or sources of funding: H.D.M. reports personal fees from Smith & Nephew, outside the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Funding: This study was funded by the Baylor Scott and White Research Institute.
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© 2021 by the Arthroscopy Association of North America