Bursae are fluid filled sacs located all over the body that enable smooth, pain-free motion between certain structures. Some bursae sit between tendons and bone. The trochanteric bursa is located between the gluteal tendons and the bony point of the hip known as the greater trochanter. When the trochanteric bursa becomes irritated and inflamed, it can cause symptoms, such as pain.
Irritation and inflammation of the trochanteric bursa (trochanteric bursitis) is most commonly caused by overuse and/or an altered gait. Some individuals with a tight iliotibial (IT) band (the muscle and tendon tract that runs between the outer hip to the outer knee) may also develop trochanteric bursitis. If a given patient fails non-operative management, then surgical removal of the inflamed bursa may be recommended.
During surgery, Dr. Keller maneuvers a camera and surgical instruments through small incisions adjacent to the peritrochanteric space (space on the outside of the thigh). Dr. Keller identifies the inflamed bursa tissue with a camera and then uses instruments to remove the inflamed tissue. Some patients with an inflamed bursa also may have a tight IT band. In these patients, Dr. Keller will use a sharp device to cut a window in the IT band. The goal of creating this window is to remove the tight area of the IT band that rubs over the femur bone.
Following surgery, Dr. Keller recommends a guided physical therapy program with a licensed physical therapist. Early motion following surgery is very important, and Dr. Keller recommends that each patient either use a stationary bike or a continuous passive motion machine daily. Dr. Keller may also recommend the use of a brace to help protect the hip.