If you’re experiencing persistent pain on the outside of your hip, you might be dealing with a common condition known as trochanteric bursitis. While non-surgical treatments are often effective, for some, a surgical procedure called a trochanteric bursectomy may be the best path to long-term relief after a period of conservative management. At California Pacific Orthopaedics, our team of board-certified surgeons in San Francisco is dedicated to providing expert care and personalized treatment plans to help you get back to the activities you love.
Overview: What is Trochanteric Bursitis and Trochanteric Bursectomy?
Trochanteric bursitis, also known as a component greater trochanteric pain syndrome (GTPS), is the inflammation of the bursa over the outside of the upper, outer portion of the femur (the greater trochanter). A bursa is a small, fluid-filled sac that acts as a cushion between bones and soft tissues, reducing friction during movement. When this bursa becomes irritated and inflamed, it can cause significant pain and tenderness
For many, this condition can be managed with conservative treatments like rest, physical therapy,anti-inflammatory medications, and possibly steroid injections. However, when the pain is severe and persistent, a trochanteric bursectomy may be recommended. This is a surgical procedure to remove the inflamed bursa. In many cases, it’s performed arthroscopically, a minimally invasive technique that uses small incisions and a camera to guide the surgeon.
Why is a Trochanteric Bursectomy Done?
The primary reason for a trochanteric bursectomy is to relieve the chronic and debilitating pain of trochanteric bursitis that has not responded to other treatments. If you’ve tried the following without success, your doctor at California Pacific Orthopaedics might discuss surgery as an option:
- Rest and Activity Modification: Avoiding activities that worsen the pain.
- Physical Therapy: Exercises to strengthen the hip muscles and stretch the iliotibial (IT) band.
- Anti-inflammatory Medications: Over-the-counter or prescription medications to reduce inflammation.
- Corticosteroid Injections: Injections directly into the bursa to reduce inflammation and pain.
When these conservative treatments fail to provide lasting relief, a bursectomy can be an effective way to address the source of the pain directly. By removing the bursa, the friction and irritation are eliminated, allowing for a return to normal, pain-free function.
What to Expect: Before, During, and After the Procedure
Understanding what to expect can help ease any anxiety you may have about the procedure. Here’s a general overview of the process at California Pacific Orthopaedics:
Before the Procedure:
Your journey will begin with a thorough evaluation by one of our orthopaedic specialists in San Francisco. This will include a physical examination and a review of your medical history. Imaging tests, such as an X-ray or MRI, may be ordered to confirm the diagnosis and rule out other potential causes of your hip pain.
Once a trochanteric bursectomy is recommended, you’ll receive detailed pre-operative instructions. These may include:
- Medication adjustments: You may be asked to stop taking certain medications, such as blood thinners, before the surgery.
- Fasting: You will likely need to avoid eating or drinking for a certain period before the procedure.
- Arranging for help: You will need someone to drive you home after the surgery and to assist you for the first few days of your recovery.
During the Procedure:
A trochanteric bursectomy is typically performed as an outpatient procedure, meaning you can go home the same day. The surgery is usually done under regional or general anesthesia.
If your surgeon at California Pacific Orthopaedics recommends an arthroscopic bursectomy, the procedure will involve:
- Small Incisions: Two or three small incisions, about the size of a keyhole, will be made on the side of your hip.
- Arthroscope Insertion: A camera (an arthroscope) is inserted into one of the incisions. This allows the surgeon to see the inside of your hip on a monitor.
- Surgical Instruments: Small surgical instruments are inserted through the other incisions to remove the inflamed bursa.
- Closure: The incisions are then closed with stitches and covered with a sterile dressing.
In some cases, an open bursectomy may be necessary. This involves a larger incision to directly access and remove the bursa. Your surgeon will discuss the best approach for your specific situation.
After the Procedure:
Recovery from a trochanteric bursectomy varies from person to person, but here’s what you can generally expect:
- Immediate Post-Op: You’ll be monitored in a recovery room for a few hours before being discharged. You will be given pain medication to manage any discomfort.
- First Few Days: You will likely need to use crutches or a walker for a short period to keep weight off the affected hip. It’s important to rest and keep the incisions clean and dry.
- Physical Therapy: Your doctor will recommend a physical therapy program to help you regain strength and range of motion in your hip. This is a crucial part of your recovery.
- Return to Activities: Most people can return to their normal daily activities within a few weeks. A full return to more strenuous activities and sports may take a few months.
Finding the Right Care in San Francisco
Living with chronic hip pain can be a significant burden, affecting your ability to work, exercise, and enjoy life. If you’re struggling with trochanteric bursitis and conservative treatments haven’t provided relief, a trochanteric bursectomy may be the solution you need.
The team at California Pacific Orthopaedics is committed to providing compassionate, patient-centered care. Our experienced surgeons will work with you to develop a personalized treatment plan that meets your individual needs and goals. If you’re looking for a doctor who treats trochanteric bursitis in the San Francisco Bay Area, contact us today to schedule a consultation. We are here to help you move past the pain and get back to living your life to the fullest.
