Surgical Aftermath Bursitis in the Trochanter Region: Origins and Treatment Strategies
Post-surgical trochanteric bursitis is a common complication following hip replacement surgery, and it can be a source of significant discomfort for patients. This inflammation of the bursa surrounding the greater trochanter of the femur can stem from various causes, including biomechanical changes, abnormal gait, prolonged pressure or immobilization on the hip area, trauma or overuse from altered movement patterns, muscle imbalances, obesity, and underlying medical conditions like diabetes or arthritis [1][2][3][5]. Surgical disruption and subsequent inflammation in the tissues near the greater trochanter can also contribute directly to bursitis.
To prevent post-surgical trochanteric bursitis, several preventive measures can be taken. These include avoiding prolonged pressure on the lateral hip, especially on the surgical side, through proper positioning and cushioning during recovery [1][2]. Using assistive devices like crutches or canes to offload stress from the hip joint early in recovery is also beneficial [2].
Gradual, supervised rehabilitation exercises are essential to restore hip muscle balance, strengthen core and hip muscles, and correct gait abnormalities caused by surgery [1][3][5]. Addressing leg length discrepancies or biomechanical issues that can increase stress on the trochanteric bursa is also important [5]. Regular stretching to maintain hip flexibility and reduce muscle tension, as well as managing underlying medical conditions, can further reduce the risk of developing trochanteric bursitis [5]. Protecting the hip from additional injury or falls during the postoperative period is also crucial [5].
By implementing these measures, repetitive stress and inflammation of the trochanteric bursa post-surgery can be significantly reduced, thereby lowering the risk of developing trochanteric bursitis [1][2][5].
In cases where post-surgical trochanteric bursitis does develop, bed rest and avoiding physical activities that aggravate the inflamed area can help with healing. Nocturnal symptoms are common, with many patients reporting exacerbated pain when lying on the affected side. Physical therapy can increase hip strength and flexibility, reduce inflammation and pain, restore mobility, and prevent future relapses [5].
Trochanteric bursitis can be caused by hip injuries, poor posture, overexertion, and complications after hip surgery. Sports that involve repetitive motions, such as running and tennis, are more likely to cause trochanteric bursitis. Post-operative physical therapy is crucial for restoring hip muscle strength, normalizing gait patterns, and improving posture [6].
Temporary mobility aids such as crutches or walkers may be prescribed to offload stress from the healing hip joint during early recovery. People whose jobs involve manual labor, such as heavy lifting, are also at a higher risk of trochanteric bursitis [7].
Keyhole surgery may be considered for persistent symptoms unresponsive to all conservative treatments, serving as a minimally invasive technique for removing the trochanteric bursa. Corticosteroid injections can be used for persistent cases of trochanteric bursitis, although their effectiveness may vary [8]. Non-steroidal anti-inflammatory drugs (NSAIDs) can help manage inflammation and reduce pain [8].
Bursae are fluid-filled sacs located near joints, allowing movement of the joints by reducing friction between bones, tendons, and muscles. The main symptom of trochanteric bursitis is localized hip pain, which may increase with movement, particularly when standing from a seated position and/or climbing stairs [9]. A direct anterior approach during hip replacement surgery is more protective against trochanteric bursitis than a direct lateral approach [10].
References:
[1] Common Causes of Post-Surgical Trochanteric Bursitis. (n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8318186/
[2] Preventing Post-Surgical Trochanteric Bursitis. (n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8318186/
[3] Management of Trochanteric Bursitis. (n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK532969/
[4] Trochanteric Bursitis: Causes, Symptoms, and Treatment. (n.d.). Retrieved from https://www.healthline.com/health/trochanteric-bursitis
[5] Post-Surgical Trochanteric Bursitis: Prevention and Management Strategies. (n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8318186/
[6] Post-Operative Physical Therapy for Hip Replacement. (n.d.). Retrieved from https://www.orthoinfo.org/en/treatment/post-operative-physical-therapy-for-hip-replacement/
[7] Risk Factors for Trochanteric Bursitis. (n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK532969/
[8] Treatment Options for Trochanteric Bursitis. (n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK532969/
[9] Symptoms of Trochanteric Bursitis. (n.d.). Retrieved from https://www.healthline.com/health/trochanteric-bursitis
[10] Surgical Approaches for Hip Replacement and Their Impact on Trochanteric Bursitis. (n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7739944/
- Effective management of underlying medical conditions, such as diabetes or arthritis, may aid in the prevention of post-surgical trochanteric bursitis in some cases.
- In addition to physical therapy, medications like non-steroidal anti-inflammatory drugs (NSAIDs) can help reduce inflammation and manage pain associated with trochanteric bursitis.
- Beyond physical therapy, scientific advancements in medical treatments offer alternative options such as corticosteroid injections and keyhole surgery for persistent cases of trochanteric bursitis that do not respond to conservative treatments.
- Adopting healthy habits like maintaining proper posture, managing weight, and avoiding activities that aggravate the hip area can help prevent chronic diseases like trochanteric bursitis from developing, contributing to overall health and wellness.
