Note: GTPS Greater trochanteric pain syndrome; Where cell values were less than 5 Fisher Exact tests was used. The clinical, functional and biomechanical presentation of patients with symptomatic hip abductor tendon tears. A clearer understanding of the relationship between GTPS and hip OA is important for further research into the treatment of GTPS and consequently patient management. Group differences were seen for BMI, but not obesity. There is a small amount of evidence suggesting that individuals with GTPS have somatosensory impairments [32, 33], which could contribute to the development of hip OA. Julie Cooke, Email: ua.ude.arrebnac@ekooc.eiluj. What are the comparative (disability, quality of life and clinical function) outcomes of people with GTPS and an asymptomatic control cohort at one and 11-years following initial assessment for GTPS? Greater trochanteric pain syndrome (GTPS), previously known as trochanteric bursitis, affects 1.8 per 1000 patients annually [1]. A double blind randomised control trial investigating the efficacy of platelet rich plasma versus placebo for the treatment of greater trochanteric pain syndrome (the HIPPO trial): a protocol for a randomised clinical trial. A prospective 11-year natural history study. Bazett-Jones DM, Cobb SC, Joshi MN, Cashin SE, Earl JE. The research was undertaken in accordance with the Declaration of Helsinki. 12-month follow-up gait speed: GTPS n=30. d Different instructions were inadvertently used at the 11-year follow-up than baseline. However, limited evidence is available on the long-term outcomes of people with GTPS. Ferrer-Pena R, Calvo-Lobo C, La Touche R, Fernandez-Carnero J. Hip-Joint Posture and Movement Alterations Are Associated With High Interference of Pain in the Life of Patients With Greater Trochanteric Pain Syndrome. A prospective 11-year natural history study. Puhr R, Heinze G, Nold M, Lusa L, Geroldinger A. Firth's logistic regression with rare events: accurate effect estimates and predictions? Initial ethics approval was provided by the ACT Health HREC (HTH.7/07.663), and the Australian National University (HREC: 2007/0062). 2005;55(512):199204. Both groups had similar levels of quality of life and measures of function. Greater Trochanteric Pain Syndrome - Physiopedia The underlying pathology is thought to primarily be due to gluteus medius and gluteus minimus tendinopathy [2, 3]. Trochanteric bursitis (greater trochanter pain syndrome). Maximum isometric hip abduction (in supine) and external rotation strength (in prone) were assessed using the same fixed calibrated hand-held dynamometer, (Chatillon, MSC FL, USA) as used at baseline assessment" [10]. Google Scholar. Where measures were close to these cut off (<15 of internal rotation in 90 flexion, or <115 flexion in supine) a goniometer was used to measure the range. For many years, this condition was believed to be caused by trochanteric bursitis, with treatments targeting the bursitis. However, we repeated the clinical examination using alternative criteria [13], with very similar results. JAMA. Mr Knotts salary was funded by Canberra Health Services. They are not included in this analysis. This bursa is at the top, outer side of the femur, between the insertion of the gluteus medius and gluteus minimus muscles into the greater trochanter of the femur and the femoral shaft. Ferrer-Pena R, Moreno-Lopez M, Calvo-Lobo C, Lopez-de-Uralde-Villanueva I, Fernandez-Carnero J. Christmas C, Crespo CJ, Franckowiak SC, Bathon JM, Bartlett SJ, Andersen RE. LB was a major contributor to the writing of the manuscript. The diagnosis of hip OA is more accurate when performed in combination with a radiographic examination [11]. FADDIR/FABER/internal rotation) and on imaging (x-ray or MRI)), systemic inflammatory disease, a history of hip or spinal surgery, for the GTPS group a cortisone injection into the lateral hip within the last 3 months and for the ASC group any history of hip pain [1, 10]. Number (%), evaluated using X 2 or Fisher Exact Testa. van Herk IEH, Arendzen JH, Rispens P. Ten-metre walk, with or without a turn? Subject to manuscript acceptance, at that point, the data from this study will be uploaded to that platform. Greater Trochanteric Pain Syndrome: More than Bursitis and I - LWW GTPS participants had more co-morbidities than the ASC group at baseline and at 12-month follow-up, but not at the 11-year follow-up, Table Table1.1. 2011;92(1):7682. CSI Corticosteroid injection - numbers carried forwards. IK collected and interpreted the participant data regarding clinical diagnosis and function. Further, at this time there appeared to be a smaller between group difference in the disability scores (mHHS and ODI). Between group differences evaluated with between the Median (IQR) via the Independent-samples Mann-Whitney U Testa. Gluteus medius and minimus muscles contribute to stabilising the head of femur within the acetabulum whilst walking [31]. In this cohort, people with GTPS were more likely to continue to experience hip pain 11-years after baseline assessment when compared to an ASC group. AF interpreted the data and was a major contributor to the writing of the manuscript. As noted above LB was trained and supervised by AF. Glyn-Jones S, Palmer A, Agricola R, Price A, Vincent T, Weinans H, et al. Terms and Conditions, This finding highlights the need to identify effective treatments that address the underlying impairments associated with GTPS. Qual Life Res. Relationship of Dynamic Balance Impairment with Pain-Related and Psychosocial Measures in Primary Care Patients with Chronic Greater Trochanteric Pain Syndrome. Kong A, Van der Vliet A, Zadow S. MRI and US of gluteal tendinopathy in greater trochanteric pain syndrome. Google Scholar. Often it can ." Mehmet Gem on Instagram: "Often patients with non responsive lateral hip pain are pushed from pillar to post. All the 11-year follow-up assessments were performed by a successfully blinded assessor (LB), a final year physiotherapy student, trained and supervised in the assessment techniques by the senior author who has 20 years of clinical experience in diagnosing hip conditions (AF). Our findings support and extend the findings of Lievense (2005) [5] who, in a retrospective questionnaire based study found 29% of participants continued to report GTPS symptoms, with 24% reporting both GTPS and hip OA diagnosis at five years follow-up. The GTPS group walked more slowly at baseline (gait speed, p<0.001) than the ASC, and were slower on the TUG at the 11-year follow-up than the ASC, Table Table22. In addition, we question whether it would be ethical to expose the participants to hip x-rays when it is not difficult to clinically diagnose symptomatic hip OA [13, 37]. HHS Vulnerability Disclosure, Help The post-hoc analysis of the alternative method to diagnose hip OA did not change the overall outcome (Additional file 1), thus we report using the Altman criteria [11]. This difference was not present at 12-months, or at 11-years. Greater trochanteric pain syndrome: epidemiology and associated factors. AF supervised the collected and analysis of the participant data. Allison K, Wrigley TV, Vicenzino B, Bennell KL, Grimaldi A, Hodges PW. This study was approved by university human research ethics committees (HREC: 20181528), all participants provided informed consent. 2015;351:h5983. AF undertook the design and conception of the study. official website and that any information you provide is encrypted BMJ. National Library of Medicine Association of hip pain with radiographic evidence of hip osteoarthritis: diagnostic test study. Further, a significantly higher proportion of people with GTPS went on to develop hip OA, than the ASC group. Tijssen M, van Cingel R, van Melick N, de Visser E. Patient-Reported Outcome questionnaires for hip arthroscopy: a systematic review of the psychometric evidence. BMC Musculoskelet Disord. Kong A, Van der Vliet A, Zadow S. MRI and US of gluteal tendinopathy in greater trochanteric pain syndrome. Fearon AM, Cook JL, Scarvell JM, Neeman T, Cormick W, Smith PN. Greater trochanteric pain syndrome - MedlinePlus Ferrer-Pena R, Calvo-Lobo C, La Touche R, Fernandez-Carnero J. Hip-Joint Posture and Movement Alterations Are Associated With High Interference of Pain in the Life of Patients With Greater Trochanteric Pain Syndrome. Further, a significantly higher proportion of people with GTPS went on to develop hip OA, than the ASC group. 1). Kennedy DM, Stratford PW, Wessel J, Gollish JD, Penney D. Assessing stability and change of four performance measures: a longitudinal study evaluating outcome following total hip and knee arthroplasty. 18.2% of the GTPS had both GTPS and hip OA, while close to 80% of the ASC remained free of hip pain, Fig. Federal government websites often end in .gov or .mil. However, limited evidence is available on the long-term outcomes of people with GTPS. Nevertheless, we can confidently compare between groups at each time point but not within the groups across the different follow-up periods. Our GTPS participants demonstrated a much higher rate than this. Subject to manuscript acceptance, at that point, the data from this study will be uploaded to that platform. Lateral Hip Pain: Relation to Greater Trochanteric Pain Syndrome. LB contributed to the design, collected, analysis and interpreted the participant data regarding clinical diagnosis and function. GTPS is a chronic condition: people with GTPS at baseline had twice the odds of being clinically diagnosed with GTPS or hip OA than the control group at 11-years. Folia Morphol (Praha). The management of greater trochanteric pain syndrome: A systematic literature review. Thus, addressing this issue early may be beneficial. Significance level was set at p<0.05. Released 2017.Version 25.0. However, limited evidence is available on the long-term outcomes of people with GTPS. The management of greater trochanteric pain syndrome: A systematic At 11-year follow-up 20/24 GTPS and 19/20 ASC participants were clinically assessed for GTPS and hip OA, completed the 10 metre-walk-test, timed up and go, and hip abduction and external rotation strength testing. *Statistically significant (p<0.05). To answer question 1 and 2, we undertook Fisher Exact evaluations. the contents by NLM or the National Institutes of Health. 2015;20(6):80513. A large proportion of GTPS participants had gone on to develop hip OA, while none of the ASC had gone on to develop hip OA according to Altmans criteria (Fisher exact, p=0.002), OR [95%CI] = 21.6 [2.30, 2898.0]. BMC Musculoskeletal Disorders The natural history of greater trochanteric pain syndrome: an 11-year follow-up study. c One participant requested this examination be ceased due to hip pain. These findings should be confirmed with a larger study. Knee Surg Sports Traumatol Arthrosc. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. trouble walking hip stiffness swelling or warmth around your hip clicking when you move your hip What causes greater trochanteric pain syndrome? At each time point, the average of these measures is reported. Hip abduction and external rotation strength, normalised to mass (kgf/mBMavg) [19], Gait speed via the 10-meter walk test (10mwt) (m/s) [20]. We did not undertake that analysis. J Arthroplasty. Ibrahim M, Kartus J-T, Steigen SE, Olsen R, Meknas K. More tendon degeneration in patients with shoulder osteoarthritis. Nevertheless, we can confidently compare between groups at each time point but not within the groups across the different follow-up periods. J Clin Epidemiol. Demographic measures are presented using median and interquartile ranges (IQR). At 11-years all participants completed the modified Harris Hip Score (mHHS), Oswestry Disability Index (ODI) and Assessment of Quality-of-Life questionnaire. Two groups [GTPS group (n=24), asymptomatic control (ASC) group (n=20)] were evaluated at baseline, 12-months and 11-years. the number of co-morbidities via the Functional Co-morbidities Index (FCI) [18]. FADDIR/FABER/internal rotation) and on imaging (x-ray or MRI)), systemic inflammatory disease, a history of hip or spinal surgery, for the GTPS group a cortisone injection into the lateral hip within the last 3 months and for the ASC group any history of hip pain [1, 10]. Causes. AF undertook the design and conception of the study. The TUG was performed in the standard manner, however the instructions were inadvertently varied from the original study [10]. Fearon AM, Ganderton C, Scarvell JM, Smith PN, Neeman T, Nash C, et al. Thus, addressing this issue early may be beneficial. 2. Group differences were seen for BMI, but not obesity. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Note: GTPS Greater Trochanteric Pain Syndrome, ASC Asymptomatic Control Group, yr year, FCI Functional Co-morbidity Index, BMI Body Mass Index, IQR Interquartile range, *Statistically significant (p<0.05). See home treatments 2 When you may need a provider Your pain is moderate to severe