Purpose
The primary purpose of this study was to systematically review the literature on intraoperative
findings during endoscopic treatment for greater trochanteric pain syndrome (GTPS).
Secondary outcomes were preoperative imaging findings and postoperative functional
outcome measures.
Methods
Medline, PubMED, and Embase databases were searched from inception (1946, 1966, and
1974, respectively), to July 15, 2021, for records reporting intraoperative findings
during endoscopic surgery for GTPS. Studies of Level I-IV evidence were eligible.
All studies were assessed for quality using the Methodological Index for Non-Randomized
Studies (MINORS) score.
Results
Sixteen studies met the inclusion criteria. Most patients underwent endoscopic greater
trochanteric bursectomy with repair of the gluteal tendons. Intraoperative conditions
reported were gluteal tendon tears usually involving the gluteus medius tendon, labral
tears, and chondral lesions. Three studies reported an average of 9% of patients who
subsequently underwent conversion to total hip arthroplasty. Pain was assessed using
the visual analog scale, and functional outcome measures were measured using the modified
Harris Hip Score, Non-Arthritic Hip Score, Hip Outcome Score Sport-Specific subscale,
Hip Outcome Score Activities of Daily Living subscale, and iHOT-12. Pain and functional
outcomes demonstrated significant improvement in nearly all the studies where they
were reported.
Conclusions
Patients who underwent endoscopic management of GTPS commonly underwent repair of
gluteal tendon tears, and in many cases had concomitant labral tears and chondral
lesions identified intraoperatively. There were low rates of adverse events, repair
failure, and revision surgery. Patient-reported functional outcomes were improved
at follow-up at least 1 year postoperatively.
Level of Evidence
IV, systematic review of level IV or better investigations
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Article info
Publication history
Published online: July 07, 2022
Accepted:
June 23,
2022
Received:
February 7,
2022
Footnotes
See commentary on page 865
The authors report the following potential conflicts of interest or sources of funding: O.R.A. reports being an educational consultant for the Speakers Bureau of ConMed. J.R.L. reports personal fees from Conmed Linvatec and Smith and Nephew, and royalties from Conmed Linvatec, during the conduct of the study. O.M.-P. reports personal fees from DePuy J&J and Cardinal Health and nonfinancial support from Heraeus, outside the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2022 by the Arthroscopy Association of North America
