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Trochanteric bursitis; Total hip arthroplasty; Risk factors; Postoperative complications; Pain management; Rehabilitation strategies

Introduction

Trochanteric bursitis is a common inflammatory condition affecting the bursa located over the greater trochanter of the femur, often resulting in pain and functional limitations [1]. It is particularly relevant in the context of total hip arthroplasty (THA), a widely performed surgical procedure aimed at alleviating pain and restoring function in patients with hip joint pathologies. Despite its overall success, THA can be complicated by various postoperative issues, including trochanteric bursitis, which can significantly hinder recovery and impact patient satisfaction [2]. The etiology of trochanteric bursitis is multifactorial, with potential contributing factors including surgical techniques, patient demographics, and pre-existing conditions [3]. Risk factors such as advanced age, female gender, obesity, and pre-existing musculoskeletal disorders have been associated with an increased likelihood of developing this condition after THA. Furthermore, the choice of surgical approach and postoperative rehabilitation strategies can influence the incidence of bursitis. Identifying these risk factors is crucial for healthcare providers to implement preventive measures and tailor postoperative care plans. By understanding which patients are at higher risk, clinicians can better manage postoperative expectations, optimize rehabilitation protocols, and improve overall outcomes [4-6]. This review aims to synthesize current knowledge regarding the risk factors associated with trochanteric bursitis following total hip arthroplasty, providing insights into the mechanisms behind its development and offering recommendations for prevention and management.

Results and Discussion

The analysis of the literature regarding trochanteric bursitis following total hip arthroplasty (THA) identified several key risk factors that contribute to the development of this condition: Advanced age is consistently associated with a higher incidence of trochanteric bursitis [7]. Older patients often exhibit reduced tendon elasticity and muscular strength, which can exacerbate postoperative complications. Females are found to be at a greater risk, potentially due to anatomical differences and hormonal factors that affect tendon and bursa health. Increased body mass index (BMI) is a significant risk factor, as excess weight can lead to increased mechanical stress on the hip joint and surrounding structures. Patients with a history of conditions such as osteoarthritis, rheumatoid arthritis, or prior hip injuries are more prone to developing trochanteric bursitis after THA. These underlying issues can affect tissue integrity and healing. Patients with diabetes may experience delayed healing and increased inflammation, contributing to a higher likelihood of bursitis. The choice of surgical technique, such as the direct lateral or posterior approach, may influence the incidence of trochanteric bursitis [8]. Some studies suggest that the lateral approach, while effective for THA, may lead to greater trauma to surrounding soft tissues, increasing the risk of inflammation. Longer surgical times and higher intraoperative blood loss have also been correlated with increased postoperative complications, including bursitis. The type and intensity of postoperative rehabilitation can impact recovery. Inadequate or overly aggressive rehabilitation may lead to complications such as bursitis. Adherence to postoperative activity modifications plays a critical role in recovery [9]. Non-compliance with recommended restrictions can exacerbate symptoms and lead to inflammation.

The findings underscore the multifactorial nature of trochanteric bursitis following THA, emphasizing the need for a comprehensive approach to patient assessment and management. Recognizing high-risk patients through careful evaluation of demographic, clinical, and surgical factors can inform preoperative counseling and postoperative care plans. For older adults and those with pre-existing musculoskeletal conditions, targeted interventions such as tailored rehabilitation programs and ongoing monitoring may help mitigate the risk of developing bursitis. Furthermore, adopting surgical techniques that minimize soft tissue trauma, alongside careful management of operative variables, can contribute to better outcomes. Postoperative education regarding activity restrictions and adherence to rehabilitation protocols is vital for patients at risk. Providing clear guidelines and support can empower patients to actively participate in their recovery, potentially reducing the incidence of complications such as trochanteric bursitis [10]. Future research should focus on the long-term outcomes of different surgical approaches and rehabilitation strategies, as well as the effectiveness of targeted preventive measures. A better understanding of these factors will enhance the ability of clinicians to optimize care for patients undergoing total hip arthroplasty, ultimately improving surgical outcomes and quality of life.

Conclusion

Trochanteric bursitis is a notable complication following total hip arthroplasty (THA) that can significantly affect patient recovery and quality of life. This review highlights several key risk factors associated with the development of trochanteric bursitis, including demographic characteristics (such as age and gender), pre-existing medical conditions (like obesity and musculoskeletal disorders), surgical techniques, and postoperative rehabilitation practices. Identifying patients at higher risk for this condition allows for tailored preoperative counseling and the implementation of preventive strategies. By optimizing surgical approaches, enhancing rehabilitation protocols, and promoting patient adherence to activity modifications, healthcare providers can potentially reduce the incidence of trochanteric bursitis post-THA. Continued research is essential to further explore the complexities surrounding this condition, including the long-term implications of various management strategies. A multidisciplinary approach that incorporates these insights will ultimately improve patient outcomes and enhance the overall success of total hip arthroplasty.

Acknowledgement

None

Conflict of Interest

None

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