Surgical Technique: Endoscopic Trochanteric Bursectomy

Abstract

As arthroscopic procedures for intra-articular hip pathology have increased in popularity and frequency, there has been a natural progression of thought to expand the reach of this minimally invasive technique to other areas of the pelvic region. With improvements in surgical instruments, fluid management systems, and improved diagnostics, endoscopy of the peritrochanteric space has become technically possible, and pathology in this compartment has been found to be amendable to arthroscopic treatment. Greater trochanteric bursitis (GTB) is an important cause of hip pain and is readily treatable via endoscopic techniques. This pathology may be evaluated with plain radiographs including an AP pelvis and 45° Dunn lateral and weight-bearing false profile, as well as CT, ultrasound, and MRI. Nonoperative management of GTB is preferred and can be successful the majority of the time, and when pain persists despite the above management techniques, an injection of local anesthetic and corticosteroid directed to the GTB area can be effective. Failure of conservative treatment is an indication for endoscopic treatment which can be a reliable and successful treatment in the properly indicated patient.