Platelet-Rich Plasma Versus Surgery for the Management of Recalcitrant Greater Trochanteric Pain Syndrome: A Systematic Review
Authors: Walker-Santiago R, Wojnowski NM, Lall AC, Maldonado DR, Rabe SM, Domb BG
DOI: 10.1016/j.arthro.2019.09.044
Background:
Greater Trochanteric Pain Syndrome (GTPS) is a frequent cause of lateral hip pain, often resistant to conservative management. This systematic review evaluates the comparative effectiveness of platelet-rich plasma (PRP) injections and surgical intervention for patients with recalcitrant GTPS after failed physical therapy.
Methods:
The review synthesized data from studies including 94 patients treated with PRP and 185 treated surgically, focusing on patient-reported outcomes and complication rates.
Key Findings:
- Both interventions improved pain and function.
- PRP injections were associated with greater improvements in outcomes and no major complications.
- Surgical treatment, while effective, had higher risks including re-tears and venous thrombosis.
Conclusions:
PRP is a safe, minimally invasive, and clinically effective alternative to surgery in the management of recalcitrant GTPS. Surgical options, particularly endoscopic approaches, remain valuable but carry higher complication risks.
What Does This Mean for Providers?
- Consider PRP as a first-line intervention for patients with GTPS unresponsive to physical therapy before escalating to surgery.
- PRP offers a favorable safety profile and may reduce the need for invasive procedures.
When surgery is indicated, endoscopic techniques should be prioritized over open procedures due to lower complication rates.