Endoscopic Treatment of Greater Trochanteric Pain Syndrome of the Hip by Randy Mascarenhas, Rachel M. Frank, Simon Lee, Michael J. Salata, Charles Bush-Joseph, and Shane J. Nho JBJS Reviews Volume 2(12):e2 December 9, 2014 ©2014 by The Journal of Bone and Joint Surgery, Inc.

The trochanteric pain sign is elicited by abducting and externally rotating the hip with the patient supine and the hip in 90° of flexion. The trochanteric pain sign is elicited by abducting and externally rotating the hip with the patient supine and the hip in 90° of flexion. Randy Mascarenhas et al. JBJS Reviews 2014;2:e2 ©2014 by The Journal of Bone and Joint Surgery, Inc.

FABERE testing is performed with flexion, abduction, external rotation, and extension of the hip. Randy Mascarenhas et al. JBJS Reviews 2014;2:e2 ©2014 by The Journal of Bone and Joint Surgery, Inc.

Figs. 3A and 3B Coronal T1-weighted (Fig. 3A) and T2-weighted (Fig Figs. 3A and 3B Coronal T1-weighted (Fig. 3A) and T2-weighted (Fig. 3B) MRI sequences of the right hip, showing hyperintensity lateral to the greater trochanter, suggestive of gluteus medius tendinopathy or tearing (white arrows). Figs. 3A and 3B Coronal T1-weighted (Fig. 3A) and T2-weighted (Fig. 3B) MRI sequences of the right hip, showing hyperintensity lateral to the greater trochanter, suggestive of gluteus medius tendinopathy or tearing (white arrows). Randy Mascarenhas et al. JBJS Reviews 2014;2:e2 ©2014 by The Journal of Bone and Joint Surgery, Inc.

Portals are made with the leg in extension and abduction, with fluoroscopy being used to localize the lateral aspect of the greater trochanter. Portals are made with the leg in extension and abduction, with fluoroscopy being used to localize the lateral aspect of the greater trochanter. ASIS = anterior superior iliac spine, and DALA = distal anterolateral accessory portal. Randy Mascarenhas et al. JBJS Reviews 2014;2:e2 ©2014 by The Journal of Bone and Joint Surgery, Inc.

Figs. 5A through 5D Endoscopic views showing the inflamed trochanteric bursa (Fig. 5A), the iliotibial band (Fig. 5B), the iliotibial band during endoscopic lengthening (Fig. 5C), and the final appearance of the lengthened iliotibial band tendon (Fig. 5D). Figs. 5A through 5D Endoscopic views showing the inflamed trochanteric bursa (Fig. 5A), the iliotibial band (Fig. 5B), the iliotibial band during endoscopic lengthening (Fig. 5C), and the final appearance of the lengthened iliotibial band tendon (Fig. 5D). ITB = iliotibial band. The asterisks indicate the vastus lateralis. Randy Mascarenhas et al. JBJS Reviews 2014;2:e2 ©2014 by The Journal of Bone and Joint Surgery, Inc.

Figs. 6A and 6B Endoscopic visualization of a normal gluteus medius tendon (Fig. 6A) and a gluteus medius tear (Fig. 6B). Figs. 6A and 6B Endoscopic visualization of a normal gluteus medius tendon (Fig. 6A) and a gluteus medius tear (Fig. 6B). Randy Mascarenhas et al. JBJS Reviews 2014;2:e2 ©2014 by The Journal of Bone and Joint Surgery, Inc.

Figs. 7A through 7F Endoscopic views showing the repair of an injured gluteus medius tendon. Figs. 7A through 7F Endoscopic views showing the repair of an injured gluteus medius tendon. Fig. 7A The injured tendon. Fig. 7B The greater trochanter is decorticated with use of a high-speed burr to encourage healing of the gluteus medius repair. Fig. 7C A suture anchor is placed in the greater trochanter. Figs. 7D and 7E Sutures are passed through the gluteus medius tendon with use of a penetrator, and the sutures are retrieved. Fig. 7F Final endoscopic view of a completed gluteus medius repair. Randy Mascarenhas et al. JBJS Reviews 2014;2:e2 ©2014 by The Journal of Bone and Joint Surgery, Inc.