Normalizing hip muscle strength: establishing body-size-independent measurements. 2002;51(4):3468. As no clinical assessment was reported for their baseline or follow-up data, it is not clear if the hip OA existed at baseline, or if a higher proportion of their cohort may have had hip OA. Hip pain is a common cause of pain and disability in older people [25]. At each time point, the average of these measures is reported. 24 It can be caused by a cam deformity, which is bony overgrowth of the femoral head and neck, a pincer. 2013;201(5):10836. All authors read and approved the final manuscript. Between group differences in quality of life seen at baseline are not found at the 11-year follow-up. Lievense A, Bierma-Zeinstra S, Schouten B, Bohnen A, Verhaar J, Koes B. Prognosis of trochanteric pain in primary care. The research was undertaken in accordance with the Declaration of Helsinki. 1999;8(3):20924. Greater trochanteric pain syndrome (GTPS) is a musculoskeletal condition which can cause disability and reduce quality of life. Segal NA, Felson DT, Torner JC, Zhu Y, Curtis JR, Niu J, Nevitt MC; Multicenter Osteoarthritis Study Group. Altman R, Alarcon G, Appelrouth D, Bloch D, Borenstein D, Brandt K, et al. Alternatively, a history of total hip arthroplasty for hip OA on the affected side was considered a diagnosis of hip OA [12]. In 60-64 year old people the estimated prevalence of radiological diagnosis of hip OA ranges from 0.5%-11.5% [26]. Provided by the Springer Nature SharedIt content-sharing initiative. 2017;36(14):230217. Greater trochanteric pain syndrome is a common cause of lateral hip pain, encompassing a spectrum of disorders, including trochanteric bursitis, abductor tendon pathology, and external coxa saltans. Glyn-Jones S, Palmer A, Agricola R, Price A, Vincent T, Weinans H, et al. As per the baseline [1, 10], we assessed: As per the baseline, four reliable and valid clinical tests were undertaken by LB. HHS Vulnerability Disclosure, Help Greater trochanteric pain syndrome: a review of anatomy - PubMed Causes. trouble walking hip stiffness swelling or warmth around your hip clicking when you move your hip What causes greater trochanteric pain syndrome? Spine (Phila Pa 1976). Howell G, Biggs R, Bourne R. Prevalence of abductor mechanism tears of the hips in patients with osteoarthritis. However, there are no longitudinal studies to indicate if the conditions arise concurrently or sequentially. J Hip Preserv Surg. We also found that many of the dysfunctions, quality of life and functional outcome differences seen at baseline between the GTPS and ASC groups had diminished, or no longer existed, at 11-years follow-up (Table 3). We recruited 44 (GTPS = 24, ASC = 20) of the 54 eligible past participants. They are not included in this analysis. Hip pain is a common cause of pain and disability in older people [25]. Therefore, our research questions were: What is the GTPS status of a GTPS cohort and an asymptomatic control cohort at 11-years follow-up? 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. Both groups had similar levels of quality of life and measures of function. LB contributed to the design, collected, analysis and interpreted the participant data regarding clinical diagnosis and function. The natural history of greater trochanteric pain syndrome: an 11-year statement and The 10mwt was completed four times with participants instructed to walk at a fast and safe pace and to start on ready, set, go!. Data were visually assessed for normality and found to be skewed. Further, Kim et al (2015) demonstrated a potential inconsistency between clinical and radiographic diagnosis of early OA in the hip [36] meaning that imaging may have biased our results. In most instances, GTPS is due to a gluteus medius or gluteus minimus tendinopathy, with variable involvement of the regional bursae. Data from the same leg is reported for each data collection point. Folia Morphol (Praha). 2016;33(11):192146. Hip pain is a common cause of pain and disability in older people . At 11-year follow-up 45.0% of GTPS participants had GTPS compared to 5.3% of ASC participants (p=0.008), OR [95% CI]: 10.19 [1.95, 104.3], and 35.0% of GTPS participants were clinically diagnosed with hip OA compared to none of the ASC participants (p=0.002), OR [95% CI]: 21.6, [2.3, 2898.0]. They are not included in this analysis. 2016;11(5):725. doi: 10.1016/j.arth.2012.10.016. 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. Greater trochanteric pain syndrome negatively affects work, physical activity and quality of life: a case control study. official website and that any information you provide is encrypted Future studies should investigate biomechanical and somatosensory impairments and their effects on joint contact forces. At 11-years all participants completed the modified Harris Hip Score (mHHS), Oswestry Disability Index (ODI) and Assessment of Quality-of-Life questionnaire. Puhr R, Heinze G, Nold M, Lusa L, Geroldinger A. Firth's logistic regression with rare events: accurate effect estimates and predictions? sharing sensitive information, make sure youre on a federal Greater trochanteric pain syndrome (GTPS) causes pain on the lateral side of the hip with subsequent dysfunction which negatively impacts quality of life and reduces the ability to remain in full-time work, compared to healthy age matched controls [1]. Further, at this time there appeared to be a smaller between group difference in the disability scores (mHHS and ODI). 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. We also found that many of the dysfunctions, quality of life and functional outcome differences seen at baseline between the GTPS and ASC groups had diminished, or no longer existed, at 11-years follow-up (Table (Table33). Arthritis Rheum. Introduction. Two groups [GTPS group (n=24), asymptomatic control (ASC) group (n=20)] were evaluated at baseline, 12-months and 11-years. Cates HE, Schmidt MA, Person RM. Previous consent had been obtained from the participants at the baseline assessment for later follow-up, all participants reconsented for the 2019 follow-up assessment. An official website of the United States government. Greater trochanteric pain syndrome (GTPS) is a musculoskeletal condition which can cause disability and reduce quality of life. Our findings support and extend the findings of Lievense . the contents by NLM or the National Institutes of Health. Bookshelf Greater trochanteric pain syndrome: epidemiology and associated factors. For many years, this condition was believed to be caused by trochanteric bursitis, with treatments targeting the bursitis. At the 12-month follow-up, our GTPS cohort reported apparent improvements in quality of life. Greater trochanteric pain syndrome negatively affects work, physical activity and quality of life: a case control study. The small sample size means the results must be considered with caution. 1, 2 GTPS is the cause of hip pain in 10-20% of patients presenting with hip pain to primary care, with an incidence of 1.8 patients per 1000 per year. 18.2% of the GTPS had both GTPS and hip OA, while close to 80% of the ASC remained free of hip pain, Fig. Greater trochanteric pain syndrome (GTPS) is a musculoskeletal condition which can cause disability and reduce quality of life. Terms and Conditions, Shbeeb MI, Matteson EL. 8600 Rockville Pike A prospective 11-year natural history study. 2013;201(5):10831086. Greater trochanteric pain syndrome (formerly trochanteric - UpToDate . At 11-years all participants completed the modified Harris Hip Score (mHHS), Oswestry Disability Index (ODI) and Assessment of Quality-of-Life questionnaire. Metcalfe D, Perry DC, Claireaux HA, Simel DL, Zogg CK, Costa ML. All authors read and approved the final manuscript. Gait Posture. Google Scholar. The small sample size means the results must be considered with caution. (Fig.1).1). doi: 10.2214/AJR.12.10038. Thus, addressing this issue early may be beneficial. Further, a significantly higher proportion of people with GTPS went on to develop hip OA, than the ASC group. The natural history of greater trochanteric pain syndrome: an 11-year follow-up study, https://doi.org/10.1186/s12891-021-04935-w, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/, bmcmusculoskeletaldisorders@biomedcentral.com. The diagnosis of hip OA is more accurate when performed in combination with a radiographic examination [11]. The greater trochanter is located at the top of the thighbone (femur) and is the most prominent and widest part of the hip. 2023 Jan 2;10(1):48-56. doi: 10.1093/jhps/hnac050. 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]. Subject to manuscript acceptance, at that point, the data from this study will be uploaded to that platform. PubMed Central Incorrect posture. While informative, this primary care, GP based study was limited by the low follow-up rate (54%), the retrospective design, lack of a clinical interview or examination to confirm the diagnosis and the absence of imaging findings at any point in the study. Hawthorne G, Richardson J, Osborne R. The Assessment of Quality of Life (AQoL) instrument: a psychometric measure of health-related quality of life. Greater trochanteric pain syndrome (GTPS) is a debilitating condition characterized by lateral hip pain located at or around the greater trochanter. For continuous data, between group differences were examined using independent-samples Mann-Whitney U tests. Dr Fearon and Dr Cookes salaries were paid for by the University of Canberra. Google Scholar. The functional anatomy of hip abductors. Methods: Trochanteric bursitis (greater trochanter pain syndrome). The single prognostic study on GTPS (n=164) reported at least 36% of people at 1-year and 29% of people at 5-years post diagnosis still had GTPS, with 24% self-reporting concurrent hip osteoarthritis (OA) [5]. A total of 85 participants were originally recruited from the local community via professional networks and word-of-mouth between March 2008 and November 2009. -, Long SS, Surrey DE, Nazarian LN. BMC Musculoskelet Disord. In 1958, Leonard ( 25) called this condition "trochanteric syndrome," reflecting the multitude of causes for pain localized to the "trochanter major.". Fairbank JC, Pynsent PB. To answer question 1 and 2, we undertook Fisher Exact evaluations. Trials. Incidence and prevalence of lower extremity tendinopathy in a Dutch general practice population: a cross sectional study. Faculty of Health, University of Canberra, 11 Kirinari St, Bruce, ACT, 2617, Australia, Research Institute for Sport and Exercise, University of Canberra, 11 Kirinari St, Bruce, ACT, 2617, Australia, Trauma and Orthopaedic Research Centre at the Canberra Hospital, Garren, ACT, 2606, Australia, Canberra Health Services, 20 Guraguma St, Bruce, 2617, Australia, You can also search for this author in 1). Shbeeb MI, Matteson EL. To account for body size effect on hip strength, strength data was standardised to participant body mass via the body mass average index (BMavg) [19]. These findings should be confirmed with a larger study. Br J Gen Pract. Arch Phys Med Rehabil. 2010;39(3):1313. Greater trochanteric pain syndrome - Wikipedia 2014 Feb;29(2):383-6. doi: 10.1016/j.arth.2012.10.016. We clinically assessed 20 (64.5%) and recorded patient reported outcomes for 24 (77.4%) of eligible GTPS participants. 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. PubMed Management of the greater trochanteric pain syndrome: a systematic Perm J. Play or work activities that cause overuse or injury to the joint areas. Richardson J, Sinha K, Iezzi A, Khan M. Modelling the utility of health states with the Assessment of Quality of Life (AQoL) 8D instrument: overview and utility scoring algorithm. All data presented in this study including patient reported and clinical examination results relate to the index leg. Relationship of Dynamic Balance Impairment with Pain-Related and Psychosocial Measures in Primary Care Patients with Chronic Greater Trochanteric Pain Syndrome. In addition, we only evaluated the original symptomatic leg, thus clinical tests that relied on both legs may have been compromised. GTPS participants had a lower quality of life than ASC participants at baseline (p=0.004). We did not undertake that analysis. 2009;467(3):623. Int J Sports Phys Ther. We attempted to contact all remaining participants (n=54), regardless of their symptomatic status, to invite to take part in this 11-year follow-up study. Cite this article. In addition, we only evaluated the original symptomatic leg, thus clinical tests that relied on both legs may have been compromised. In the absence of a condition specific measure for this population at baseline, measures with face validity were used. 2016;17(1):16. Demographic measures are presented using median and interquartile ranges (IQR). 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. We note that our two groups had no difference in strength so other factors such as motor control or somatosensory impairments may also be contributing factors. Greater trochanteric pain syndrome: Evaluation and management of a wide Greater trochanteric pain syndrome (GTPS), previously known as trochanteric bursitis, affects 1.8 per 1000 patients annually. Groll DL, To T, Bombardier C, Wright JG. While informative, this primary care, GP based study was limited by the low follow-up rate (54%), the retrospective design, lack of a clinical interview or examination to confirm the diagnosis and the absence of imaging findings at any point in the study. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip. Pain Med. However, limited evidence is available on the long-term outcomes of people with GTPS. Clinicians involved in treating people with GTPS should be aware that over time their management strategies may need to change. AF supervised the collected and analysis of the participant data. 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]. Incidental rotator cuff tear of the hip at primary total hip arthroplasty. Who gets gluteal tendinopathy? Another bursa called the iliopsoas bursa is on . Time up and go: lower score is more desirable. 1). Finally, we did not undertake reliability studies, however LB was trained and supervised by AF who undertook the original study, and we used outcomes with published high inter-rater reliability.
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