Arthroscopic bursectomy for recalcitrant trochanteric bursitis after hip arthroplasty.

This study evaluated the use of arthroscopic bursectomy for pain relief in patients with trochanteric bursitis after hip arthroplasty. In this retrospective case series of 12 patients undergoing arthroscopic treatment of recalcitrant trochanteric bursitis after hip arthroplasty, outcomes were assessed via phone interview with a numeric pain rating scale from 1 to 10 and were compared with preoperative pain ratings. Patients were asked the percentage of time they had painless hip function and whether they would have the surgery again. At an average 36-month follow-up (range, 4-85 months), the average numeric pain scale rating improved from 9.3 to 3.3. At an average of 62% of the time, patients had painless use of the hip. Ten of 12 patients in the study felt the pain relief gained was substantial enough to warrant having procedure again. In these patients, arthroscopic bursectomy was a viable option for patients with recalcitrant bursitis after hip arthroplasty.

Arthroscopic bursectomy for recalcitrant trochanteric bursitis.

PURPOSE: The purpose of this prospective study was to evaluate the arthroscopic treatment of trochanteric bursitis in patients who have not responded to nonoperative treatment. METHODS: Thirty patients were enrolled in this study to evaluate the results of arthroscopic bursectomy. Outcomes were assessed by use of a visual analog pain scale, Harris Hip Score, Short Form 36 Health Survey, and additional specific hip function questions. Patients were given the self-administered outcome questionnaires before surgery and at subsequent follow-up visits. Of the patients, 25 were available for a mean follow-up of 26.1 months (range, 13.8 to 41 months). RESULTS: Pain scores on the visual analog scale improved from a preoperative mean of 7.2 (0, no pain; 10, worst pain) to a postoperative mean of 3.1 at final follow-up (P = .0001). Mean Harris Hip Scores improved from a mean of 51 preoperatively to 77 at follow-up (P = .0001). Improvements were also noted in the physical component summary scores of the Short Form 36. The mean physical function score improved from 33.6 preoperatively to 54 at follow-up (P = .022), and in the pain category, the mean score improved from 28.7 to 51.5 (P = .001). One postoperative complication occurred, a seroma that required repeat surgery. One patient had a failed arthroscopic bursectomy and subsequently underwent open bursectomy with resolution of symptoms. CONCLUSIONS: Arthroscopic bursectomy appears to be an effective option for recalcitrant trochanteric bursitis and is a viable alternative to open bursectomy. In this prospective study patients had good pain relief and improved function compared with their preoperative status. Improvements in a patient's status are usually evident by 1 to 3 months after surgery and appear to be lasting. LEVEL OF EVIDENCE: Level IV, therapeutic case series.

Are all cementless acetabular components created equal?

The cementless acetabular components used over the past 2 decades have varied in type of ingrowth fixation, supplemental fixation, locking mechanisms, and bearing surface. We evaluated 15-year follow-up results from 2 cementless acetabular components: the Harris-Galante I (HG; Zimmer, Warsaw, IN) and the PCA (Howmedica, Rutherford, NJ), in terms of revision and radiographic loosening. Three of the 120 HG I acetabular components were revised for wear and osteolysis without loosening. Seventeen of the 100 PCA components were revised for aseptic loosening (with or without osteolysis). Including those cases revised, 21 PCA acetabular components were loose radiographically, and no HG I component was loose. At least with these 2 first-generation designs, differences were seen in performance of the acetabular component in terms of revision and loosening at 15 years.