Greater Trochanteric Pain Syndrome: An Intraoperative Endoscopic Classification System with Pearls to Surgical Techniques and Rehabilitation Protocols
Authors: Lall AC, Schwarzman GR, Battaglia MR, Chen SL, Maldonado DR, Domb BG
DOI: 10.1016/j.eats.2019.04.004
Background:
Greater Trochanteric Pain Syndrome (GTPS) is a common source of lateral hip pain, often stemming from gluteal tendinopathy, bursitis, or abductor tears. While most cases respond to conservative treatment, surgical intervention is indicated in refractory cases. This study presents a novel endoscopic intraoperative classification system to standardize treatment decisions.
Methods:
The authors introduce a five-type intraoperative classification based on tendon integrity, retraction, and associated pathology. Each type corresponds to recommended surgical techniques and postoperative rehabilitation protocols.
Key Findings:
- The classification aids intraoperative decision-making and standardizes treatment based on pathology severity.
- Helps guide the use of techniques like bursectomy, IT band release, partial vs. full gluteus medius repair, and augmentation.
- Tailored rehab protocols improve recovery efficiency and protect repair integrity.
Conclusions:
Using a structured classification for GTPS during surgery improves surgical consistency, communication, and outcome prediction. This system supports personalized surgical and rehab strategies.
What Does This Mean for Providers?
- Apply the intraoperative classification to guide the choice of surgical technique and ensure appropriate rehabilitation timelines.
- Improves interdisciplinary communication between surgeons, therapists, and care teams.
- Enhances outcome predictability and supports better patient counseling preoperatively.