AI Article Synopsis
- - Greater trochanteric pain syndrome (GTPS), commonly affecting older women, leads to significant lifestyle limitations and is often treated conservatively, but some patients remain unresponsive, prompting exploration of percutaneous ultrasound tenotomy (PUT) as a potential solution.
- - A study involving 48 patients with persistent trochanteric pain due to iliotibial band tendinopathy measured pain and functional outcomes before and one year after undergoing PUT, with assessments focusing on activities like sit-to-stand and walking.
- - Results showed a significant reduction in pain levels, with a 4-point improvement on the Numeric Rating Scale and 70% of patients reporting pain relief at the one-year mark, indicating PUT's effectiveness as a treatment for
Article Abstract
Background: Upper lateral hip pain is a common complaint in adults and is referred to as greater trochanteric pain syndrome (GTPS) and is more prevalent among older women. This is a debilitating condition that could result in lower physical activity and quality of life, and higher unemployment rate. GTPS is a clinical diagnosis, and many cases improve with conservative medical management (CMM). However, there is still a gap between patients not responding to CMM and those who are not good surgical candidates. Thus, percutaneous ultrasound tenotomy (PUT) may be a valuable treatment option to limit this gap.
Objectives: Demonstration of the one-year pain and functional outcomes, including sit to stand.
Setting: Academic tertiary care medical center.
Methods: Forty-eight consecutive patients with refractory trochanteric pain due to iliotibial band (ITB) tendinopathy. Fifty-six hips were treated; 8 patients underwent bilateral procedures. Electronic medical record review of consecutive patients who underwent ITB TENEX® was performed at Montefiore Medical Center from December 2019 to December 2021. Institutional guidelines recommended TENEX® for greater trochanteric pain refractory to conservative treatment and ultrasound (US) confirmed ITB tendinopathy (hypoechogenicity or thickened tendon > 6 mm). Pain level, as well as sit-to-stand, side-lying, and walking tolerance levels were evaluated at baseline preprocedure visit and one-year visit. Follow-up was performed by independent practitioners and corroborated by chart review.
Results: Numeric Rating Scale (NRS-11) improved by 4 points across all patients. Seventy percent of patients endorsed pain relief at one-year visit. Median preprocedure NRS-11 was 9. The reported median NRS-11at one year was 5 (Wilcoxon signed rank NRS-11 demonstrated a Z score of -6.042 with P < 0.001). One-year analysis among all patients revealed 57%, 78%, and 66% improvement in side-lying, sit-to-stand, and walking tolerance levels, respectively.
Limitations: We believe that our results must be confirmed with a randomized control trial with a control arm and more patients included.
Conclusions: PUT of the ITB using the TENEX® tissue remodeling device could be a safe and effective treatment for ITB tendinopathy-associated GTPS.
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