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MEDICINA DELLO SPORT

A Journal on Sports Medicine


Official Journal of the Italian Sports Medicine Federation
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ORTHOPAEDIC AND TRAUMATOLOGIC SECTION  


Medicina dello Sport 2006 September;59(3):349-54

language: Italian

The trochanteric syndrome in athletes practicing endurance sports: surgical treatment in refractory cases

Migliorini S. 1, Merlo M. 2

1 Medicina Federale F.I.TRI., Roma
2 Struttura Semplice di Traumatologia dello Sport e Chirurgia Protesica, Ospedale di Busto Arsizio, Varese


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The trochanteric bursitis incidence in athletes practicing endurance sports is increasing. The trochanteric bursitis is caused by an acute trauma or repeated microtraumas associated with other factors such as training errors, anatomical factors, biomechanics of running, training surfaces, athletic shoes, cycling-running transition in triathlon. From a biomechanic and etiopathogenetic point of view, it seems there are between the rotator-cuff lesion of the shoulder and the trochanteric syndrome. The final result is the degeneration of the tendons inserting in the greater trochanter, the trochanteric bursitis and an excessive tension of the iliotibial band of the tensor fascia lata. The majority of athletes with trochanteric bursitis respond positively to conservative therapy that consists of stretching, cryotherapy, physiotherapy, local infiltration of anaestetic and corticosteroid, rest or reduction of the amount of training. However, there are few rare cases that do not respond to conservative therapy. Surgery management of trochanteric bursitis consists of a simple longitudinal incision of the iliotibial band of the tensor fascia lata over the grater trocahanter, that is not repaired, and excision of the trochanteric bursa. Before being operated the athletes had suffered from a minimum of a year to a maximum of six years and, after operation, all of them returned to practice sports even to agonistic high level. The average Harris Hip Score was 95.

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