Distal lengthening of ilio-tibial band by Z-plasty for treating refractory greater trochanteric pain after total hip arthroplasty (Pedersen-Noor operation).
BACKGROUND
The development of greater trochanteric pain (GTP) after total hip arthroplasty (THA) represents a special category. Despite that treatment is mainly conservative, some patients show poor response and surgical intervention should be considered. We propose a new method consisting of distal lengthening of ilio-tibial band (ITB) by Z-plasty.


METHODS
Between March 2004 and June 2006, 12 women with refractory GTP after THA were operated on using distal ITB lengthening. The procedure was done under local anaesthesia on an outpatient basis. The patients were followed up 3-4 months postoperatively by phone interview and at 1-3 years by EQ-5D questionnaire and clinical examination including tenderness evaluation with algometer.


RESULTS
All patients improved significantly (EQ-5D = 0.26 preoperatively vs. 0.67 postoperatively; P < 0.005) except one patient who experienced no change in GTP symptoms. No postoperative complications were reported.


CONCLUSIONS
We believe that treating patients with GTP after THA by the technique described offers a simple, safe and reliable method.
Sayed-Noor
Arkan S
AS
Department of Orthopaedic Surgery, Sundsvall Hospital, 851 86 Sundsvall, Sweden. arkansam@yahoo.com
Pedersen
Eskild
E
Wretenberg
Per
P
Sjödén
Göran O
GO
D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D002062:Bursitis / Q000601:surgery*; D005260:Female; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D010149:Postoperative Pain / Q000601:surgery*; D013536:Suture Techniques; D013710:Tendons / Q000601:surgery*