Hip - Bursitis
Description
Trochanteric bursa is a thin, protective layer of tissue found between the top of the iliotibial band (IT band) and the greater trochanter of the femur (thigh bone). Bursa exists in an effort to keep the ITB from rubbing on the femur. Bursa can become inflamed and thickened, resulting in symptoms of trochanteric bursitis.
What are the causes?
Bursitis generally occurs as a result of overuse or trauma. Patients that participate in sports like running, wrestling and cycling are prone to bursitis due to the recurrent friction between the IT band and the trochanter.
What are the symptoms?
Bursitis causes pain on the side of the hip directly over the trochanter. Patients may feel pain at the bump on the outside aspect of the hip, particularly at night. Night pain is relieved by motion, however increases with excessive exercise.
How is it diagnosed?
Your surgeon will perform a thorough history and physical exam, which typically includes X-rays. The outside aspect of the hip is tender to touch, but motion and strength should be preserved. If your pain is accompanied by a significant loss of strength, indicative of a gluteus medius muscle tear, your surgeon may order an MRI.
Non-operative
Non-operative treatment of bursitis is usually the first line of treatment. Your surgeon may recommend anti-inflammatory medicine, physical therapy, and/or cryotherapy to help reduce the pain and inflammation. An injection may help resolve the pain.
Platelet Rich Plasma (PRP) Injections is another non operative option. Blood is taken from your arm and is spun down to get the healthiest healing factors - platelets and serum. Once injected, the platelets degranulate and release activate growth factors and cytokines to promote healing. One injection may be all you need, however, there are times where multiple injections may provide additional benefit. Not covered by insurance.
Mesenchymal Stem Cell Injections is another non operative option. Bone marrow is aspirated from your pelvis and centrifuged in a special kit to concentrate the stem cells, which are then reinjected into the hip. The goals are to change the living microenvironment of the tendon, up regulating collagen formation, and promote tendon cell healing and reorganization. Not covered by insurance.
Operative
If non-operative treatment fails to relieve the pain, your surgeon may suggest surgery. A minimally-invasive arthroscopic surgery or open incision can be used to remove the inflamed and thickened bursa. Postoperative medication and physical therapy is at your surgeon’s discretion.
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Rehabilitation
Following surgery, a short rehabilitation period can be expected. Most patients find that using a cane or crutches for a couple of days is helpful. It is reasonable to be up and walking around the evening after surgery. The soreness from surgery usually goes away after a few days.
Prevention
Although hip bursitis cannot always be prevented, there are things you can do to prevent the inflammation from getting worse.
- Avoid repetitive activities that put stress on the hips.
- Lose weight if you need to.
- Get a properly fitting shoe insert for leg-length differences.
- Maintain strength and flexibility of the hip muscles.