Abstract Background: Greater trochanteric pain syndrome (GTPS) is a common yet frequently underdiagnosed cause of lateral hip pain following hip arthroplasty (HA), with potential implications for patient satisfaction, mobility, and long-term functional outcomes. While the surgical focus during total HA has conventionally centered on prosthetic alignment and fixation, increasing attention is being directed toward soft-tissue preservation. The trochanteric bursa, often excised or left unrepaired, may serve a biomechanical role in cushioning and facilitating gliding of the iliotibial band and gluteal tendons over the greater trochanter. Objective: The objective is to determine the incidence of GTPS in patients undergoing primary HA with intraoperative trochanteric bursa repair through the posterior approach and to evaluate associated functional and symptomatic outcomes at short- to mid-term follow-up. Materials and Methods: A retrospective observational study was conducted at a single tertiary care center, including 25 patients who underwent primary unilateral HA, either a total hip replacement or hemiarthroplasty through the posterior approach with documented repair of the trochanteric bursa between August 2023 and September 2024. Inclusion criteria included adults aged 40–80 years undergoing HA for primary osteoarthritis or femoral neck fractures with a minimum clinical follow-up of 12 months. Exclusion criteria included revision HA, previous ipsilateral hip surgery, abductor tendon tears, and postoperative complications such as infection or dislocation. The primary outcome was the incidence of GTPS, defined by persistent lateral hip pain and focal tenderness over the greater trochanter persisting beyond 3 months postoperatively. Secondary outcomes included lateral trochanteric pain during daily activities and lying on the operative side, as well as pain scores (Visual Analog Scale VAS) and functional status (Harris Hip Score HHS) at 3, 6, and 12 months. Results: All 25 patients completed a minimum follow-up of 12 months. Functional outcomes improved progressively over time, with the mean HHS increasing from 60.12 at 3 months to 93.16 at 12 months. Lateral hip pain demonstrated a sustained reduction across follow-up. Pain during routine activities decreased from a mean VAS score of 4.32 at 3 months to 0.84 at 12 months, while pain while lying on the operated side decreased from 5.28 to 1.16 over the same period. Improvements in both pain and functional outcomes were observed consistently at each follow-up interval. Conclusion: In this observational cohort, no cases of clinically diagnosed GTPS were observed following primary hemiarthroplasty via the posterior approach with trochanteric bursa repair. While this differs from previously reported rates, efficacy cannot be inferred. The findings support the safety and feasibility of bursal repair in the early postoperative period and suggest a potential role for peri-trochanteric soft-tissue management that merits evaluation in comparative studies.
Jhanjharya et al. (Tue,) studied this question.