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Contrasting Force Reduction at the Greater Trochanter Using Different Surgical Procedures for Relief of Greater Trochanteric Pain Syndrome
Author(s) -
Taylor Victor,
Wood Addison,
Belmares Ricardo,
Guttmann Geoffrey,
Reeves Rustin
Publication year - 2016
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.30.1_supplement.778.14
Subject(s) - greater trochanter , medicine , cadaver , lesser trochanter , fascia , ischial tuberosity , surgery , reduction (mathematics) , femur , thigh , anterior superior iliac spine , anatomy , orthodontics , geometry , mathematics
Greater Trochanteric Pain Syndrome (GTPS) is associated with hip pain from repeated trauma to the greater trochanter bursa. Surgical procedures cut the iliotibial tract (ITT) in order to relieve the pressure around the greater trochanter. We propose that the ITT may not be the primary cause of GTPS. In this study, we hypothesize the primary cause of GTPS is the force generated by the gluteus maximus (gmax) tendon where it inserts onto the gluteal tuberosity of the femur. METHODS Force measurements were made using a K‐scan portable tactile pressure measurement system (Tekscan, Inc., S. Boston, MA). Tests were performed on 6 unembalmed cadavers. Cadavers were stabilized on a gurney at the hip. The skin on the top half of the thigh was reflected and superficial fascia removed to expose the ITT. A 7cm incision was made between the ITT and tensor fascia latae muscle. Next, a force sensor pad was placed in the incision between the greater trochanter and ITT. Three categories were used for motion measurements: normal (no cut), ITT cut, and gmax cut. For each category, a range of motions was measured at 0º, 10º, and 15º adduction while subjected to 0º, 10º, 20º flexion and/or extension. Each measurement was made in triplicates. RESULTS A total of 12 hips were observed in the study. Two‐way Analysis of Variance statistical analysis was used to compare force generated from the normal (uncut) hips to hips with either the gmax tendon or ITT cut. Preliminary results indicate more reduction in force in the hips with the ITT cut; however, some relief of force over the greater trochanter was seen with the gmax tendon cut. CONCLUSION Taking into account the surgical approaches, the gmax tendon cut is the more invasive procedure, and these data suggest the ITT cut to be more effective at relieving force on the greater trochanter, with much less trauma to the patient. More studies will be conducted in the future.