TROCHANTERIC BURSITIS SURGERY

Trochanteric Bursitis

The hip has two large bursae which are jelly-like sacs located where friction occurs between bones and soft tissue to help reduce painful rubbing and inflammation. 

The greater trochanteric bursa is associated with the iliotibial (IT) band, the long tendon running down the side of your thigh and attaching to the knee’s outside edge. If the tendon is pulled too tightly during walking, running or other sporting activities, it will press and rub against the bursa, leading to trochanteric bursitis.

A bursectomy of the hip and iliotibial band (ITB) release is commonly performed by Dr Singh if non-operative measures, such as rest, ice and physiotherapy have not adequately alleviated the trochanteric bursitis inflammation and pain. If surgery is required, participating in a tailored exercise program before your procedure (pre-hab) with a physiotherapist will help facilitate the best post-surgical result possible.

The surgical procedure

A bursectomy of the hip and iliotibial band (ITB) release procedure starts off with you being wheeled into the operating bay and meeting with a member of the anaesthesia team. The most common types of anaesthesia used in a trochanteric bursitis surgical procedure are general anaesthesia (you are put to sleep) or spinal, epidural, or regional nerve block anaesthesia (you are awake, but your body is numb from the waist down). 

The anaesthetist, with your input, will determine which type of anaesthesia will be best for you.

After the anaesthetist has administered your anaesthetic and the nerves that supply your tummy, hips, bottom, and legs have been numbed, Dr Singh will make an incision in the side of your thigh over the area of the greater trochanter. The the iliotibial band is then split vertically so that the trochanteric bursa and the bone of the greater trochanter can be seen. The inflamed bursae is then carefully removed, the bone of the greater trochanter is smoothed, and any bone spurs are removed. The skin is then closed with stitches.

The procedure takes Dr Singh approx. 45 minutes from start to finish

Immediately after trochanteric bursitis surgery

Immediately after trochanteric bursitis surgery, you will be wheeled into a recovery room on your ward bed and given oxygen to help you breath. Leads will be on your chest to monitor your heart rate, and an intravenous line (drip) will be in your arm which dispenses fluid and paracetamol for the first 24-36 hours following your procedure. 

When you wake up in the recovery ward, you may feel a bit groggy. Dr Singh and the hospital team will monitor you, checking your blood pressure, temperature, and pulse. You will usually only spend 1-2 hours in the recovery room before being taken to your room on the ward.

Whilst on the ward, the nursing team at the hospital will help you perform your normal day to day activities as required. It usually only takes a few hours to recover fully from the anaesthetic, and the nurse with regularly check on your recovery. 

Your hospital stay following trochanteric bursitis surgery is usually only one night with most people going home the following morning. 

In the first week following surgery, you may experience some discomfort and swelling in the hip area. There may also be some bruising and incision warmth which is normal.

For the first 2 weeks after surgery, your activity level is usually limited however you will be able to walk independently, use the bathroom and perform normal daily activities.

After 2 weeks, you will be able to engage in moderate activities, such as driving a car and climbing stairs.

Within 6 weeks, you should be able to resume most of your normal activities. 

Recovery timelines following trochanteric bursitis surgery

It is important to realise that the speed in your recovery depends largely on the extent and type of tearing/tendinosis along with other related factors. Partial thickness tears that have not completely separated from the bone or complete tears that are identified early (acute) tend to recover fastest. Chronic tears (present for > 6 months) that have completely separated from the bone (retracted) tend to form scar tissue and adhesions, which can complicate surgical repair and prolong recovery. 

For most patients, timelines following hip abductor repair surgery are as follows:

  • Day 1: Go home on the same day as surgery (or the next day)
  • Day 1-2: Resume normal, daily household activities
  • Day 3-5: Stop taking prescription pain medications
  • Day 7-10: return to a desk-job with intermittent walking 
  • 2 Weeks: Drive a car (chronic/retracted tears may take longer)
  • By 4 – 6 weeks: Walking unassisted and without a limp (acute/partial thickness) or 3 months (chronic/retracted)
  • By 8 – 10 weeks: You can start running again (acute/partial thickness) or 3 – 4 months (chronic/retracted)
  • 2 – 3 months (acute/partial thickness) return to unrestricted sports participation or a labour-intensive occupation or 4 – 6 months (chronic/retracted)

Post-surgical physiotherapy & rehabilitation 

Physiotherapy is required following surgery to ensure that you get the best possible outcome. With the guidance of your physio, you will progressively advance through various stages of your rehabilitation, as outlined in our post-operative protocol and your Physiotherapist will have some flexibility to safely modify your progression to meet your specific goals and expectations.

Potential surgical risks

Trochanteric bursitis surgery/hip abductor repair surgery is generally a very successful procedure however, as with all surgical procedures there are certain risks and potential complications. 

Blood clots: Clots (deep venous thrombosis or DVT) can occur in the veins of the legs after any surgery

Infection: This is a very serious complication which occurs in approximately 1% of cases. 

Although uncommon, the Midwest Orthopaedics team take the following precautions to further minimise this risk: 

  • prior to surgery, your skin is tested to ensure resistant organisms are not present
  • your limb is prepared with antiseptic on the ward prior to surgery
  • intravenous antibiotics are used at the time of surgery 
  • the surgical team are required to wear special, self-enclosed theatre gowns
  • any infection that develops after surgery is treated immediately

Failure of the Repair: (although very rare, 1-2%) due to poor tendon/muscle tissue

Fracture: Rare, however it is possible for the trochanter to crack during surgery.

Discovering any potential problems before surgery drastically reduces the risk of any of these complications from occurring.

Estimate of Fees

As a privately insured patient at Midwest Orthopaedics, typically, costs associated with surgery are as follows:

Your initial consultation fee, review consultation fee & Dr Singh’s surgical fees.

Your level of healthcare and your provider greatly influence your out-of-pocket expenses, so we recommend that you check with your health fund prior to booking in for surgery.

Other related charges include the Anaesthetist, the surgical assistant, the hospital fees and any in-patient pathology and radiology charges if x-rays or scans were required.

In the Australian public health care system, there is universal cover provided through Medicare. This means that all Australian residents can be treated with no out of -pocket costs incurred. Dr Singh does operate in the public sector at Geraldton Regional Hospital however, the waiting list to even meet with him can be long (too long), followed by even longer waiting lists for your operation. 

Because of this, an increasing number of people are choosing to “Self-Insure” or pay for their own surgery even without private health insurance. This is often a worthwhile investment as it means you can have your operation done straight away or whenever it suits you. All the private hospital fees associated with your surgery are an out-of-pocket expense for self-pay surgeries and we will assist you in obtaining an estimate of costs from the private hospital before you go ahead with your procedure.

Discover more about hips

HIP ANATOMY
HIP CONDITIONS
HIP SURGERY

Dr Aman Singh

M.B.ChB(NZ), FRACS (ortho)

Dr Singh works closely with local physiotherapists, radiologists, and other allied health members to ensure that your condition is treated without surgery where appropriate, or that post-operative recovery is as comprehensive as possible.

Dr Aman Singh

M.B.ChB(NZ), FRACS (ortho)

Dr Singh works closely with local physiotherapists, radiologists, and other allied health members to ensure that your condition is treated without surgery where appropriate, or that post-operative recovery is as comprehensive as possible.