PDF(Pubmed)
Abstract：
BACKGROUND: Greater trochanteric pain syndrome (GTPS) presents challenges in clinical management due to its chronic nature and uncertain etiology. Historically attributed to greater trochanteric bursitis, current understanding implicates abductor tendinopathy as the primary cause. Diagnosis usually involves a clinical examination and additional tests such as imaging and provocative testing. Surgical intervention may be considered for cases refractory to conservative therapy, with endoscopic techniques gaining ground over open procedures.
METHODS: A systematic review was conducted adhering to the PRISMA guidelines. Relevant studies were searched in four databases: Pubmed, Scopus, Embase, and Medline. The selected articles were evaluated according to the criteria of levels of evidence (LoE). The Coleman methodology score (mCMS) was used to analyze the retrospective studies. This systematic review was registered in the International Prospective Registry of Systematic Reviews.
RESULTS: Surgical success rates ranged from 70.6-100%, significantly improving pain and function. Complications were generally mild, mainly hematomas and seromas, while recurrence rates were low. However, limitations such as the retrospective design and the absence of control groups warrant cautious interpretation of the results.
CONCLUSIONS: Endoscopic surgery emerges as a promising option for refractory GTPS, offering effective symptom relief and functional improvement. Despite limitations, these results suggest a favorable risk-benefit profile for endoscopic procedures. Further research is needed, particularly prospective randomized trials, to confirm these findings and optimize surgical techniques to improve patient outcomes.
METHODS: A systematic review was conducted adhering to the PRISMA guidelines. Relevant studies were searched in four databases: Pubmed, Scopus, Embase, and Medline. The selected articles were evaluated according to the criteria of levels of evidence (LoE). The Coleman methodology score (mCMS) was used to analyze the retrospective studies. This systematic review was registered in the International Prospective Registry of Systematic Reviews.
RESULTS: Surgical success rates ranged from 70.6-100%, significantly improving pain and function. Complications were generally mild, mainly hematomas and seromas, while recurrence rates were low. However, limitations such as the retrospective design and the absence of control groups warrant cautious interpretation of the results.
CONCLUSIONS: Endoscopic surgery emerges as a promising option for refractory GTPS, offering effective symptom relief and functional improvement. Despite limitations, these results suggest a favorable risk-benefit profile for endoscopic procedures. Further research is needed, particularly prospective randomized trials, to confirm these findings and optimize surgical techniques to improve patient outcomes.
摘要：
背景：大转子疼痛综合征（GTPS）由于其慢性性质和不确定的病因，在临床管理中提出了挑战。历史上归因于大转子滑囊炎，目前的理解暗示外展肌腱病是主要原因。诊断通常涉及临床检查和其他测试，例如成像和挑衅性测试。对于保守治疗难以治疗的病例，可以考虑手术干预。随着内窥镜技术在开放程序上的发展。
方法：根据PRISMA指南进行系统评价。在四个数据库中搜索了相关研究：Pubmed，Scopus,Embase,Medline根据证据水平（LoE）标准对所选文章进行评估。采用Coleman方法评分(mCMS)对回顾性研究进行分析。该系统评价已在国际前瞻性系统评价登记处注册。
结果：手术成功率为70.6-100%，显著改善疼痛和功能。并发症一般轻微，主要是血肿和血清瘤，而复发率低。然而,回顾性设计和对照组缺失等局限性需要谨慎解释结果.
结论：内镜手术成为难治性GTP的一个有希望的选择，提供有效的症状缓解和功能改善。尽管有局限性,这些结果提示内镜手术具有良好的风险-获益特征.需要进一步的研究,特别是前瞻性随机试验，确认这些发现并优化手术技术以改善患者预后。
方法：根据PRISMA指南进行系统评价。在四个数据库中搜索了相关研究：Pubmed，Scopus,Embase,Medline根据证据水平（LoE）标准对所选文章进行评估。采用Coleman方法评分(mCMS)对回顾性研究进行分析。该系统评价已在国际前瞻性系统评价登记处注册。
结果：手术成功率为70.6-100%，显著改善疼痛和功能。并发症一般轻微，主要是血肿和血清瘤，而复发率低。然而,回顾性设计和对照组缺失等局限性需要谨慎解释结果.
结论：内镜手术成为难治性GTP的一个有希望的选择，提供有效的症状缓解和功能改善。尽管有局限性,这些结果提示内镜手术具有良好的风险-获益特征.需要进一步的研究,特别是前瞻性随机试验，确认这些发现并优化手术技术以改善患者预后。
