• Sayed E Wahezi, Aakash Patel, Sandeep Yerra, Tahereh Naeimi, Dawood Sayed, Devin Oakes, Nicole Ortiz, Michelle Yee, Christopher Yih, Kishan Sitapara, Jacob Schulz, Lynn Kohan, Jared Rosenburg, Evan Schwechter, Ferdinand Chan, David Gonzalez, and Champ Baker.
• Department of Physical Medicine & Rehabilitation, Montefiore Medical Center, NY.
• Pain Physician. 2023 Jul 1; 26 (4): 393401393-401.

BackgroundUpper lateral hip pain is a common complaint in adults and is referred to as greater trochanteric pain syndrome (GTPS) and is more prevalent among older women. This is a debilitating condition that could result in lower physical activity and quality of life, and higher unemployment rate. GTPS is a clinical diagnosis, and many cases improve with conservative medical management (CMM). However, there is still a gap between patients not responding to CMM and those who are not good surgical candidates. Thus, percutaneous ultrasound tenotomy (PUT) may be a valuable treatment option to limit this gap.ObjectivesDemonstration of the one-year pain and functional outcomes, including sit to stand.SettingAcademic tertiary care medical center.MethodsForty-eight consecutive patients with refractory trochanteric pain due to iliotibial band (ITB) tendinopathy. Fifty-six hips were treated; 8 patients underwent bilateral procedures. Electronic medical record review of consecutive patients who underwent ITB TENEX® was performed at Montefiore Medical Center from December 2019 to December 2021. Institutional guidelines recommended TENEX® for greater trochanteric pain refractory to conservative treatment and ultrasound (US) confirmed ITB tendinopathy (hypoechogenicity or thickened tendon > 6 mm). Pain level, as well as sit-to-stand, side-lying, and walking tolerance levels were evaluated at baseline preprocedure visit and one-year visit. Follow-up was performed by independent practitioners and corroborated by chart review.ResultsNumeric Rating Scale (NRS-11) improved by 4 points across all patients. Seventy percent of patients endorsed pain relief at one-year visit. Median preprocedure NRS-11 was 9. The reported median NRS-11at one year was 5 (Wilcoxon signed rank NRS-11 demonstrated a Z score of -6.042 with P < 0.001). One-year analysis among all patients revealed 57%, 78%, and 66% improvement in side-lying, sit-to-stand, and walking tolerance levels, respectively.LimitationsWe believe that our results must be confirmed with a randomized control trial with a control arm and more patients included.ConclusionsPUT of the ITB using the TENEX® tissue remodeling device could be a safe and effective treatment for ITB tendinopathy-associated GTPS.

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