Endoscopie Bursectomy and Fixation of the Iliotibial Tract at the Greater Trochanter

ArticleinOrthopaedics and Traumatology 8(3):225-232 · April 2012with27 Reads
DOI: 10.1007/BF03181104

    Abstract

    ObjectivesMinimally invasive surgical procedure for removal of the trochanteric bursa and, if necessary, exostosectomy and/or fixation
    of the iliotibial tract at the greater trochanter.

    IndicationsChronic, unsuccessfully treated trochanteric bursitis. Bursitis caused by snapping hip or due to exostosis at the greater
    trochanter.

    ContraindicationsInfected bursitis or bursitis in rheumatoid patients.

    Surgical TechniqueThrough 2 approaches, cranial and caudal and slightly posterior to the tip of the trochanter, infiltration of the epitrochanteric
    area with saline (Purisole®); the iliotibial tract is divided under endoscopic control. Subtotal removal of the trochanteric bursa using a synovial resector.
    If necessary, the procedure can be extended to include a fixation of the tract with resorbable suture anchors.

    ResultsSince June 1995, we performed an endoscopic bursectomy in 34 patients (28 women and 6 men, average age 57.8 years). The first
    20 patients (18 women and 2 men, average age 52.6 years) had an average follow-up of 20 (12 to 36) months. Fifteen patients
    were satisfied with the result. The degree of pain and functional handicap was assessed using a visual analog scale (10 points
    for intense pain). This pain score amounted to 8.9 points before surgery, to 5.2 postoperatively, and to 4.3 at follow-up.
    One instance of secondary healing was seen in a stab incision.

    Key WordsTrochanteric bursitis-Endoscopic bursectomy-Tractopexy