The impact of bursa repair and steroid injection on lateral trochanteric pain following total hip arthroplasty: a retrospective cohort study

Objective: This study aimed to evaluate the clinical outcomes of preserving and repairing the bursal tissue—rather than excising it—during total hip arthroplasty (THA), and to assess the additional e!ect of administering a steroid injection into the repaired bursa.

Methods: Patients who underwent total hip arthroplasty (THA) via a posterior approach were retrospectively reviewed and divided
into three groups based on the intraoperative bursal tissue management technique. The first group (PB) included patients who received an intraoperative injection of corticosteroid (40 mg methylprednisolone) and local anesthetic (bupivacaine 5 mg/mL) into the preserved bursa. The second group (BR) consisted of patients who underwent bursal repair without injection. The third group (BE) comprised patients who underwent total excision of the bursa. Clinical outcomes were assessed using the Harris Hip Score (HHS), the Visual Analogue Scale (VAS) for pain during daily activities, and VAS for pain while lying on the ipsilateral hip at 6 and 24 months postoperatively.

Results: A total of 41 patients (27 females, 14 males) who underwent THA were included in the study. No statistically significant di!erences were observed between the groups in lateral trochanteric VAS scores during daily activities at both 6 and 24 months postoperatively (P > .05). However, a significant di!erence was found in VAS scores assessed while lying on the operated side at 6 months, favoring the PB group (P < .001). Additionally, Harris Hip Score (HHS) values were significantly higher in the PB group compared to the other groups at both 6 months (P < .001) and 24 months (P=.006).

Conclusion: Intraoperative corticosteroid and local anesthetic injection, in addition to bursa repair, may improve early postoperative
outcomes and pain relief in patients undergoing THA using the posterior approach, without increasing infection risk.

Cite this article as: Abul MS, !ahiner D, Sevim ÖF, Hekim Ö, Ergün S, Eceviz E. The impact of bursa repair and steroid injection on lateral trochanteric pain following total hip arthroplasty: a retrospective cohort study. Acta Orthop Traumatol Turc., 2025;59(4):195-200.