PRP

Greater trochanter pain syndrome

Greater trochanteric pain syndrome

 

Definition

 

Chronic lateral trochanteric pain

- abductor tendon tendonitis

- trochanteric bursitis

 

Epidemiology

 

Women 40 - 60 years old

 

Mechanism

 

? repetitive friction of iliotibial tract over GT

 

Symptoms

 

Pain over upper lateral thigh with activity

- often related to hip flexion

 

Full thickness tears

Surgical Options

 

1.  Open antero-lateral approach 

 

Large / Massive Cuff Tear

 

2.  Deltopectoral approach

 

Large Subscapularis tear

 

3.  Arthroscopic Assisted Mini-open

 

Indication

- Small / Moderate Cuff Tear < 3cm

- no retraction

 

Technique

- arthroscopic SAD

Partial thickness tears

Clinical

 

Pain & Stiffness

- often more pain than FT tears

 

Bursal side tears more painful than articular

 

Articular side more common

 

May see in young patient overhead throwing

 

Examination

 

Painful arc

 

Impingement signs

 

No weakness

- function good

Background

Definition

 

Full thickness tear (FTT)

- variable amount retraction from insertion

 

Rotator Cuff Tear Large

 

Partial thickness tear (PTT)

- incomplete

- bursal or articular sided

Adhesive capsulitis

Definition 

 

Idiopathic inflammatory condition

- characterised by progressive shoulder pain & stiffness

- due to contracture of capsuloligamentous structures

- spontaneously resolves 

 

Epidemiology

 

2% incidence

- 40 - 60 years

- Women 2:1

 

Sedentary workers

- Non-dominant limb

 

Bilateral in 10 - 40%

 

Aetiology

 

Lateral epicondylitis

Incidence

 

Lateral : Medial 9:1

 

Epidemiology

 

4th & 5th decades

- M = F

- 75% dominant arm 

 

50% of regular tennis players

- especially > 2 hrs / week

 

Aetiology

 

Insertion pathology / Enthesopathy

 

Over-extension of the elbow with supination / pronation

 

Anatomy

 

Lateral epicondyle

- anconeus from posterior face

- ECRB and EDC from anterior face (CEO)