Coulomb R, Essig J, Mares O, Asencio G, Kouyoumdjian P, May O
CHU Carémeau, place du Pr-Debré, 30029 Nîmes cedex 9, France.
Clinique Médipole-Garonne, 45, rue Gironis, 31036 Toulouse cedex 1, France.
Orthop Traumatol Surg Res. 2016 May;102(3):391-5. doi: 10.1016/j.otsr.2016.01.007. Epub 2016 Mar 3.
Various surgical treatments have been proposed for greater trochanteric pain syndrome (GTPS) related to gluteal tendinopathy with partial thickness tears. The clinical results of endoscopic debridement without repair of these gluteal tears are not well known. The objectives of this study were to determine if this procedure leads to: (1) reduction of pain, (2) functional improvement, (3) patient satisfaction (on scale of 0 to 10).
Endoscopic treatment without tendon repair provides short-term pain relief in patients with GTPS due to partial thickness gluteal tears.
Seventeen patients (16 women, 1 man) with GTPS due to partial thickness gluteal tears that was present for at least 6 months and was refractory to conservative treatment were included in the analysis. The average age at the time of the procedure was 53.5years (17-71). Pain was evaluated with a visual analogue scale (VAS). Functional outcomes were defined using the Harris Hip Score and the UCLA activity score. Satisfaction was evaluated using a VAS and Odom's criteria.
The average follow-up was 37.6months (12-48). The average preoperative and follow-up values were respectively: (1) Pain: 7.2±1.1 (5-9) versus 3.3±1.9 (1-7) (P<0.001), (2) Harris score: 53.5±8.4 (36-68) versus 79.8±14.7 (45-96) (P<0.001). Seven patients (41.2%) were able to resume sports activities. The average satisfaction score for the surgery was 6.2±2.4 (0-9) at follow-up. Five patients had a poor outcome at the review: four still had pain and one had recurrence of the lateral snapping hip.
Endoscopic treatment without repair of partial thickness gluteal tears is a treatment option with modest clinical results for GTPS patients refractory to conservative treatment.
IV, retrospective study.
对于与臀肌腱病伴部分厚度撕裂相关的大转子疼痛综合征（GTPS），已经提出了多种手术治疗方法。内镜下清创而不修复这些臀肌撕裂的临床效果尚不清楚。本研究的目的是确定该手术是否能带来：（1）疼痛减轻，（2）功能改善，（3）患者满意度（0至10分）。
对于因臀肌部分厚度撕裂导致的GTPS患者，不进行肌腱修复的内镜治疗可提供短期疼痛缓解。
17例因臀肌部分厚度撕裂导致GTPS且病程至少6个月、保守治疗无效的患者（16例女性，1例男性）纳入分析。手术时的平均年龄为53.5岁（17 - 71岁）。采用视觉模拟量表（VAS）评估疼痛。使用Harris髋关节评分和加州大学洛杉矶分校（UCLA）活动评分定义功能结果。使用VAS和奥多姆标准评估满意度。
平均随访37.6个月（12 - 48个月）。术前和随访时的平均数值分别为：（1）疼痛：7.2±1.1（5 - 9）对3.3±1.9（1 - 7）（P<0.001），（2）Harris评分：53.5±8.4（36 - 68）对79.8±14.7（45 - 96）（P<0.
