The impact of bursa repair and steroid injection on lateral trochanteric pain following total hip arthroplasty: a retrospective cohort study


Abul M. S., Şahiner D., Sevim Ö. F., Hekim Ö., ECEVİZ E., Ergün S.

Acta Orthopaedica et Traumatologica Turcica, cilt.59, sa.4, ss.195-200, 2025 (SCI-Expanded, Scopus, TRDizin)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 59 Sayı: 4
  • Basım Tarihi: 2025
  • Doi Numarası: 10.5152/j.aott.2025.25271
  • Dergi Adı: Acta Orthopaedica et Traumatologica Turcica
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Directory of Open Access Journals, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.195-200
  • Anahtar Kelimeler: Harris hip score, hip Lateral trochanteric pain, pain Total hip arthroplasty, Trochanteric bursa
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Objective: This study aimed to evaluate the clinical outcomes of preserving and repairing the bursal tissue—rather than excising it—during total hip arthroplasty (THA), and to assess the additional e!ect of administering a steroid injection into the repaired bursa. Methods: Patients who underwent total hip arthroplasty (THA) via a posterior approach were retrospectively reviewed and divided into three groups based on the intraoperative bursal tissue management technique. The first group (PB) included patients who received an intraoperative injection of corticosteroid (40 mg methylprednisolone) and local anesthetic (bupivacaine 5 mg/mL) into the pre served bursa. The second group (BR) consisted of patients who underwent bursal repair without injection. The third group (BE) com prised patients who underwent total excision of the bursa. Clinical outcomes were assessed using the Harris Hip Score (HHS), the Visual Analogue Scale (VAS) for pain during daily activities, and VAS for pain while lying on the ipsilateral hip at 6 and 24 months postoperatively. Results: A total of 41 patients (27 females, 14 males) who underwent THA were included in the study. No statistically significant differ ences were observed between the groups in lateral trochanteric VAS scores during daily activities at both 6 and 24 months postopera tively (P >.05). However, a significant difference was found in VAS scores assessed while lying on the operated side at 6 months, favoring the PB group (P <.001). Additionally, Harris Hip Score (HHS) values were significantly higher in the PB group compared to the other groups at both 6 months (P <.001) and 24 months (P =.006). Conclusion: Intraoperative corticosteroid and local anesthetic injection, in addition to bursa repair, may improve early postoperative outcomes and pain relief in patients undergoing THA using the posterior approach, without increasing infection risk.