Diagnostic Accuracy of Clinical Tests for Assessing Greater Trochanteric Pain Syndrome: A Systematic Review With Meta-analysis

Gluteal tendinopathy masterclass: Refuting the myths and engaging with the evidence

INTRODUCTION

Gluteal tendinopathy is a prevalent and impactful condition. For many decades clinical practice has been guided by 'myths' that developed around clinical beliefs. It's time to examine these myths and engage with the substantial evidence base.

PURPOSE

This masterclass aims to: (i) engage with the evidence to refute the most common myths associated with gluteal tendinopathy and trochanteric pain, and (ii) provide clinicians with guidance around contemporary, evidence-based clinical practice.

IMPLICATIONS

It is time to put aside traditional beliefs that focused on anti-inflammatory treatments, including rest and corticosteroid injections as first line management for trochanteric pain. Contemporary management of tendinopathy takes an active approach that empowers the individual to manage their own condition through education, load management, progressive exercise and optimisation of their general health. The body of evidence for gluteal tendinopathy supports health professionals in employing such principles with greater confidence.

Greater Trochanteric Pain Syndrome and the Efficacy of Platelet-Rich Plasma Injections: A Systematic Review

Greater trochanteric pain syndrome (GTPS) is one of the most prevalent causes of lateral hip pain. The incidence rate is as high as 1.8 patients per 1000 annually, with females predominantly affected. We compared and analysed the effectiveness of platelet-rich plasma (PRP) injections in treating GTPS. Literature search was carried out on PubMed, Embase and Cochrane by two independent reviewers using the terms: 'Greater Trochanteric Pain syndrome' and 'Platelet-rich plasma'. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and the Cochrane risk of bias tool and Methodological Index for Non-Randomized Studies (MINORS) tool were used to assess bias. Nine studies were shortlisted and reviewed for patient sample size, diagnostic modalities, the presence of tendinopathy or bursitis, the number of PRP injections administered, and the length of symptom relief achieved. We analysed nine studies between 2013 to 2024 comprising of a total of 508 patients who received treatment with PRP injections for lateral hip pain. There was an improvement and sustained relief in symptoms in eight studies, while one reported no change. Many studies indicated PRP injections to be more effective than corticosteroid injections (CSI) in treating GTPS. PRP appears to be an effective injectable treatment option for GTPS, which does not respond to conservative therapy. However, due to the limitations of the current literature, there is a need for more large-scale, high-quality randomized clinical trials to assess further the effectiveness of PRP for treating GTPS.

Warming-up for the Latest on Diagnosing and Managing Tendinopathy

SYNOPSIS: JOSPT is starting 2024 on a high, with a tendinopathy-focused edition that showcases more of the high-quality tendinopathy research you know and love in systematic reviews, original research articles, a consensus paper, and editorials. As any athlete knows, a good warm-up is crucial to performing well at the main event. Here, we help you warm up and prime your brain to take on all the content of this tendinopathy-focused issue of the Journal. J Orthop Sports Phys Ther 2024;54(1):1-2. Epub 5 December 2023. doi:10.2519/jospt.2023.12440.