Intraoperative Classification System Yields Favorable Outcomes for Patients Treated Surgically for Greater Trochanteric Pain Syndrome.

Abstract Purpose To utilize a prospectively collected database to internally validate a previously published intraoperative classification system by determining its utility in improving patient-reported outcome scores (PROS). Methods Open or endoscopic procedures performed at a single center between February 2008-March 2018 with minimum 2-year follow-up were reviewed. Patients were prospectively classified intraoperatively as one of five greater trochanteric pain syndrome (GTPS) types according to the Lall GTPS classification system and underwent one of the six following surgical procedures: trochanteric bursectomy (TB, Type I); TB with trochanteric micropuncture (Type II); endoscopic suture staple repair (Type IIIA); endoscopic single row transtendinous repair (Type IIIB); open or endoscopic double row repair (Type IV); and gluteus maximus/tensor fasciae latae transfers (Type V). The following PROS were analyzed to assess the efficacy of treatment and validity of the classification scheme: modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), The International Hip Outcome Tool (iHOT-12), Hip Outcome Score- Sport Specific Subscale (HOS-SSS), and visual analog scale for pain. Results 324 total patients (287 females, 37 males) underwent surgical management per GTPS classification type: 109 Type I; 26 Type II; 20 Type IIIA; 118 Type IIIB; 44 Type IV; and 7 Type V. The mean age and follow-up time were 51.9±12.5 years and 44.5±20.5 months, respectively. All patients PROS improved from baseline to minimum 2-year follow-up (p Conclusion This validation study supports that the classification system and treatment algorithm for surgical treatment of various GTPS types leads to favorable patient reported outcomes. These findings provide surgeons with a validated classification system and treatment algorithm to manage peritrochantric pathology diagnosed intraoperatively. Study Design Prognostic Study, Level of Evidence, 3