Background: Greater trochanteric pain syndrome (GTPS) is characterized by chronic lateral hip pain and dysfunction. While psychosocial measures of other tendinopathies have been gaining traction, GTPS is less well studied. We sought to characterize the morbidity upon presentation of GTPS and compared it to patients with end-stage, hip osteoarthritis (OA) awaiting total hip arthroplasty (THA).
Methods: This study examined patient reported outcomes measures (PROMs) on activity limitations, quality of life (QOL), pain, and level of disability, in all patients with GTPS and end-stage, pre-THA hip OA. All patients presented at a single academic medical center between October 2016 to November 2020. The PROMs were analyzed using an equivalence test and two-one-sided t-tests.
Results: A total of 156 patients (193 hips) with GTPS and 300 patients (326 hips) with hip OA were investigated. Equivalence in mean UCLA Activity score between GTPS and OA groups were established with tolerance margin of ± 5. The difference in mean UCLA score was 0.002 (95% CI -0.45 to 0.43, p \u3c 0.01) between GTPS and OA patients. Equivalence in mean VAS score between GTPS and OA were established with tolerance margin of ± 10. The difference in mean VAS score was 0.35 (95% CI -0.86 to 0.16, p = 0.02). HOOSQol score was much worse in GTPS patients, placed well outside of the ± 10 tolerance margin and difference in means score was 1.72 (95% Cl -2.17 to -1.26, p = 0.99). All estimated differences were comparable with and without the adjustment for each PROM respectively, suggesting the differences (or the lack of) in the PROMs between GTPS and OA couldn’t be explained by the differences in sex, age, BMI, race, ethnicity, or smoking status.
Conclusion: This cumulative evidence characterizes GTPS as painful and limiting in activities of daily living, as pre-THA hip OA, and with poorer quality of life scores than hip OA. This study validates results of other studies that have investigated PROMs between GTPS and pre-THA, hip OA patients. Clinicians and researchers should not underestimate the disease, and further research on characterizing the progression of the disease should be a priority
