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Surgical release of the internal obturator tendon for the treatment of retro-trochanteric pain syndrome: a prospective randomized study, with long-term follow-up

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Twelve patients with clinical signs of retro-trochanteric pain syndrome were randomized to either operative treatment or a control group. Six patients were operated on with sectioning of the tendon to the internal obturator near its insertion to the trochanter major. There was no significant pain decrease in either group at 6 months. However, at 8 years, the decrease in pain was significant in the surgical group (P < 0.03) but not in the control group. Three patients in the surgical group who needed pain medication with opioids preoperatively managed without such drugs at 8 years. Two patients in the surgical group were working half time at the 8 year follow-up. Before the start of the study the patients had been out of work for 3 and 10 years, respectively. At inclusion 4/12 patients had minor degenerative changes at the L3–L5 level as seen on computerized tomography or magnetic resonance imaging. At 8 years, the corresponding change was found in 7/9 patients (P = 0.025). In conclusion, at 8 years after surgical release of the internal obturator muscle, the patients had a significant decrease in pain compared with the finding at inclusion. The corresponding was not found in the control group.

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Acknowledgment

The authors thank Prof. James Mercer, Ph.D., Department of Medical Physiology, Institute of Medical Biology, Faculty of Medicine, University of Tromsø, Norway for assistance with language polishing.

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Authors and Affiliations

  1. Department of Orthopaedics, University Hospital of North Norway, 9038, Tromsø, Norway

    Khaled Meknas, Anders Christensen & Oddmund Johansen

  2. Faculty of Medicine, Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway

    Khaled Meknas & Oddmund Johansen

  3. Department of Orthopaedics, NU-County Hospital, Trollhättan/Uddevalla, Sweden

    Jüri Kartus

  4. Department of Physical Medicine and Rehabilitation, University Hospital of North Norway, Tromsø, Norway

    Jan Inge Letto

Authors
  1. Khaled Meknas
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  2. Jüri Kartus
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  4. Anders Christensen
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  5. Oddmund Johansen
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Correspondence to Khaled Meknas.

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Meknas, K., Kartus, J., Letto, J.I. et al. Surgical release of the internal obturator tendon for the treatment of retro-trochanteric pain syndrome: a prospective randomized study, with long-term follow-up. Knee Surg Sports Traumatol Arthrosc 17, 1249–1256 (2009). https://doi.org/10.1007/s00167-009-0787-z

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  • DOI: https://doi.org/10.1007/s00167-009-0787-z

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