Department of Orthopaedic Surgery, Hip and Knee Replacement Unit, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.
Biostatistics and Epidemiology Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.
Hip Int. 2022 Jul;32(4):530-536. doi: 10.1177/1120700020986136. Epub 2021 Jan 11.
Trochanteric bursitis or greater trochanteric pain syndrome is a common disorder and frequent cause of lateral hip pain. It can lead to severe functional impairment with increase morbidity and poor quality of life.The purpose of the current study was to identify and evaluate relationship between health-related factors, as prognostic indicators, and clinical outcomes.
A single-centre, prospective study was conducted and 60 patients (62 hips) were included with a minimum 12 months of follow-up. Clinical outcomes were evaluated using Hip Outcome Scale, Single Assessment Numeric Evaluation and Visual Analogue Scale. Radiological assessments and health-related factors were documented in an attempt to understand their validity as predictors of clinical outcomes. Complications and recurrence rates were also analyzed.
Univariate model revealed that an increased BMI ( = 0.001; OR = 1.05; 95% CI, 1.02-1.07); number of previous corticosteroid infiltrations ( = 0.001; OR = 1.28, 95% CI, 1.11-1.48); longer time from symptom onset to surgery ( = 0.001; OR = 1.19; 95% CI, 1.12-1.28); smoker status ( = 0.001; OR 11.2; 95% CI, 3.30-44.2); and the presence of prior lumbosacral fusion (LSF) ( = 0.001; OR 13.8; 95% CI, 2.96-101); were prognostic factors predisposing for poor clinical outcomes.Among prognostic health-related factors were medical comorbidities such as emotional distress ( 0.001; OR 26.1; 95% CI, 5.71-192); fibromyalgia ( = 0.026; OR 3.56; 95% CI, 1.16-11.7); and hyporthyroidism ( = 0.005, OR = 6.55, 95% CI, 1.73-28.7).
Better overall physical function was predicted by lower number of corticosteroid infiltrations, shorter time span from symptom onset to surgery, non-smoker status and the absence of prior lumbosacral fusion. Obesity, smoking, the presence of emotional distress, fibromyalgia and hypothyroidism seem to increase the risk of poor clinical outcomes. A proper selection and/or correction of modifiable prognostic factors could reduce the incidence of endoscopic treatment failure and, as a consequence, improve patient outcomes and quality of life. However, future efforts should focus on experimental and randomised studies to fully determine these associations.
转子滑囊炎或大转子疼痛综合征是一种常见疾病，也是髋关节外侧疼痛的常见原因。它可导致严重的功能障碍，增加发病率和降低生活质量。本研究的目的是确定和评估与健康相关的因素，作为预后指标，并评估其与临床结果的关系。
进行了一项单中心前瞻性研究，共纳入 60 例（62 髋）患者，随访时间至少 12 个月。使用髋关节量表、单一评估数字评估和视觉模拟量表评估临床结果。记录放射学评估和与健康相关的因素，以了解其作为临床结果预测因素的有效性。还分析了并发症和复发率。
单变量模型显示，BMI 增加（ = 0.001；OR = 1.05；95% CI，1.02-1.07）；皮质类固醇注射次数增加（ = 0.001；OR = 1.28，95% CI，1.11-1.48）；从症状出现到手术的时间延长（ = 0.001；OR = 1.19；95% CI，1.12-1.28）；吸烟者（ = 0.001；OR 11.2；95% CI，3.30-44.2）；以及先前存在腰椎骶骨融合（LSF）（ = 0.001；OR 13.8；95% CI，2.96-101）是导致临床预后不良的预后因素。与健康相关的预后因素包括情绪困扰（ = 0.001；OR 26.1；95% CI，5.71-192）；纤维肌痛（ = 0.026；OR 3.56；95% CI，1.16-11.7）；和甲状腺功能减退（ = 0.005，OR = 6.55，95% CI，1.73-28.7）等医学合并症。
皮质类固醇注射次数较少、从症状出现到手术的时间较短、非吸烟者状态和无腰椎骶骨融合的患者，整体身体功能更好。肥胖、吸烟、存在情绪困扰、纤维肌痛和甲状腺功能减退似乎会增加临床预后不良的风险。适当选择和/或纠正可改变的预后因素可以降低内镜治疗失败的发生率，从而改善患者的预后和生活质量。然而，未来的研究应侧重于实验和随机研究，以充分确定这些关联。
