Spinopelvic parameters in greater trochanteric pain syndrome: a retrospective case-control study
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SCIENTIFIC ARTICLE
Spinopelvic parameters in greater trochanteric pain syndrome: a retrospective case-control study Robin Canetti 1 & Benoit de Saint Vincent 1 & Thais D. Vieira 1 & Vincent Fière 1 & Mathieu Thaunat 1 Received: 30 September 2019 / Revised: 25 November 2019 / Accepted: 26 November 2019 # ISS 2019
Abstract Purpose Greater trochanteric pain syndrome (GTPS) is a condition resulting in lateral hip pain, most commonly caused by tendinosis or tear of the gluteus medius and minimus tendons, and greater trochanteric bursitis. Our aim was to assess pelvic parameters and proximal femoral anatomy in patients suffering from surgical-stage GTPS compared with a control group. Methods This retrospective, case-control study assessed 43 patients suffering from GTPS, matched according to age, gender, body mass index and level of sport and physical activity to 43 control patients, between 2013 and 2018. Pelvic parameters, including pelvic incidence (PI), pelvic tilt (PT) and sacral slope (SS), and proximal femoral anatomy, including femoral offset (FO) and neck-shaft angle (NSA), were measured using the EOS Imaging™ system. Results GTPS patients had a significantly lower mean (± SD) SS than control patients (33.1 ± 10.4 vs. 39.6 ± 9.7°, respectively; p < 0.05). There was no significant difference in PT (21.3 ± 7.1 vs. 19.0 ± 7.2°), PI (53.5 ± 11.6 vs. 57.7 ± 10.5°), FO (40.4 ± 8 vs. 42.2 ± 6.8°) or NSA (125.1 ± 5.8 vs. 124.4 ± 4.7°). There was no difference in lower back pain symptoms in a subgroup analysis of GTPS patients. Conclusions Sacral slope was lower in patients with surgical-stage GTPS than in asymptomatic hip patients, using the EOS Imaging™ system. Keywords Greater trochanteric pain syndrome . Sacral slope . Hip surgery . Pelvic parameters
Introduction Greater trochanteric pain syndrome (GTPS) is a condition with a wide range of causes, resulting in lateral hip pain. Initially, GTPS referred to trochanteric bursitis. However, anatomical studies have shown that these bursae are acquired in response to friction between the greater trochanter (GT) and gluteus maximus as it inserts into the fascia lata [1], and histological studies have not shown any evidence of acute or chronic inflammatory changes in the bursae of patients suffering from trochanteric bursitis [2]. GTPS is characterised by pain and reproducible tenderness in the region of the GT, buttock or lateral thigh, associated with pain at extreme hip rotation, abduction or adduction
* Mathieu Thaunat [email protected] 1
Ramsay Générale de Santé, Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, 24 Avenue Paul Santy, 69008 Lyon, France
[3]. The underlying aetiology of GTPS is most commonly tendinosis or tear of the gluteus medius and minimus tendons [4], greater trochanteric bursitis and external coxa saltans [17]. Magnetic resonance imaging (MRI) studies have shown that 88% of patients suffering from GTPS have gluteus tendinopathy [5]. GTPS is widely undiagnosed but is thought to affect up to 23.5% of women and 9% of men between 50 and
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