Efficacy of Greater Trochanteric Bursitis Embolization in Patients Refractory to Conversative Therapy

Greater Trochanteric Bursitis (GTB) is a leading cause of greater trochanteric pain syndrome and is marked by inflammation of the greater trochanteric bursa, situated between the greater trochanter and the iliotibial band. This inflammatory process is often a result of repetitive stress or trauma to the area. The purpose of this study is was to assess the safety and efficacy of greater trochanteric bursitis embolization (GTBE) in patients with greater trochanteric bursitis who are unresponsive to conservative treatments.

Materials and Methods: A retrospective review was conducted on patients who underwent GTBE between July 2023 and September 2024. A total of 32 patients with lateral hip pain secondary to GTB diagnosed by orthopedic surgery (mean age 66.8 ± 11 years; 18 right hip, 14 left hip) were referred for treatment. All patients underwent via transfemoral artery access and embolization of the medial and lateral femoral circumflex arteries with imipenem/cilastatin (IPM/CS) as the embolic agent. Angiography was utilized to identify neovascularization and/or hyperemic tissue corresponding to the region of subjective pain. Data collected included patient demographics, procedural details, technical success, visual analogue scale (VAS) scores, and peri-procedural complications. Patients were classified as "responders" if they experienced a reduction of ≥ 50% in VAS scores.

Results: Technical success was achieved in all cases, defined as successful embolization of the femoral circumflex arteries supplying the region of palpable pain. Of the 32 patients, 22 (76%) were classified as responders, 7 (24%) as non-responders, and follow-up data was unavailable for 3 patients (9%). The mean dose-area product was 51.4 (± 47) Gy·cm², and the average fluoroscopy time was 23.5 (± 8) minutes. No cutaneous changes were noted and no adverse events were observed.

Conclusion: In this population, GTBE was a safe and effective treatment for greater trochanteric bursitis in patients whose symptoms are refractory to conservative management.