Trochanteric bursectomy is an operation to remove the inflamed bursa over the outer hip (greater trochanter) and release a tight iliotibial band (ITB). It is performed for greater trochanteric pain syndrome that has not responded to non-operative treatment.
An incision is made over the outer hip. The inflamed bursa is removed. The iliotibial band may be lengthened or partially released if it is tight and contributing to snapping. Any gluteal tendon tears may be repaired at the same time. The procedure can also be performed arthroscopically through small incisions. The operation takes 45–90 minutes.
Surgery is considered for persistent lateral hip pain that has not responded to at least six months of physiotherapy, corticosteroid injection, shockwave therapy, and activity modification. It is most effective when a specific structural cause (torn gluteal tendon, thickened bursa) is identified on MRI.
Physiotherapy (gluteal strengthening programme), corticosteroid injection, shockwave therapy, and activity modification. These are effective for the majority of patients.
MRI to assess the bursa and gluteal tendons. Standard pre-assessment.
Relief of lateral hip pain. If gluteal tendon repair is included, improved hip abductor strength and reduced Trendelenburg gait.
Discomfort over the outer hip.
Local swelling for several weeks.
Some patients have persistent discomfort.
The bursa may reform.
Numbness on the outer thigh.
Wound infection.
Blood collection requiring drainage.
General or spinal anaesthesia.
Crutches for one to two weeks for comfort. Physiotherapy for gluteal strengthening begins at two weeks. Return to normal activities at six to eight weeks. Full recovery three months.
Review at two weeks and six weeks.
It is most commonly caused by gluteal tendinopathy or tears, bursitis, and ITB tightness. It is often triggered by overuse, changes in activity, or hip mechanics. It is not caused by 'bursitis' alone in most cases — the underlying gluteal tendon problem should be addressed.