AB084. SOH21AS021. Corticosteroid injection for greater trochanteric pain syndrome: a systematic review
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AB084. SOH21AS021. Corticosteroid injection for greater trochanteric pain syndrome: a systematic review

Barbara Nolan1, Dominic Harmon2

1University of Limerick School of Medicine, Castletroy, Limerick, Ireland; 2Department of Anaesthesia and Pain Medicine, Limerick University Hospital, Dooradoyle, Limerick, Ireland

Background: Greater trochanteric pain syndrome commonly causes disabling lateral hip pain and has largely replaced diagnoses including trochanteric bursitis and gluteal tendinopathy. No systematic review has examined best practice exclusively in corticosteroid injection for this condition. This review therefore aims to evaluate the efficacy of corticosteroid injection for Greater Trochanteric Pain Syndrome.

Methods: On 4/08/2020, a systematic search was completed on Cochrane, CINAHL, EMBASE and MEDLINE. Experts were contacted and bibliographies were hand-searched. Key search words included; Greater trochanteric pain syndrome, trochanteric bursitis, gluteal tendinopathy, gluteal, trochanteric, synovial bursa, corticosteroid, steroid, injection, cortisone and glucocorticoid. Eligibility criteria; Randomised controlled trials published in English which examined corticosteroid injection for a primary diagnosis Greater Trochanteric Pain Syndrome.

Results: Ten studies (n=1,141) were included; injection technique (n=2), CSI vs. other intervention (n=6), corticosteroid injection vs. placebo (n=1) and corticosteroid injection vs. no treatment (n=1). Methodological quality was varied. High-quality evidence suggests that corticosteroid injection may be significantly less efficacious in long-term outcomes versus Platelet Rich Plasma, with no differences between corticosteroid injection and placebo. Imaging-guided techniques had no significant advantage. Moderate-to-low quality studies showed that corticosteroid injection improved short-term outcomes but other treatments (exercise, Platelet Rich Plasma, extracorporeal shockwave therapy) are efficacious over a longer period.

Conclusions: Corticosteroid injection may be useful in short-term treatment for Greater Trochanteric Pain Syndrome. Landmark-guided techniques are sufficient. Future high-quality placebo-controlled trials with established diagnostic criteria are necessary to determine the role of corticosteroid injection in Greater Trochanteric Pain Syndrome.

Keywords: Corticosteroid injection; gluteal tendinopathy; greater trochanteric pain syndrome; trochanteric bursitis

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-21-ab084
Cite this abstract as: Nolan B, Harmon D. SOH21AS021. Corticosteroid injection for greater trochanteric pain syndrome: a systematic review. Mesentery Peritoneum 2021;5:AB084.

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