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Had greater trochanter hip fracture. Suggested chronic bursitis. Can this be cured without the need for narcotics?

Jul 2013
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Answered by

Orthopaedic Surgeon, Joint Replacement
Practicing since : 1996
Answered : 2148 Questions
I had a greater trochanter hip fracture after my third right hip replacement found by a second opinion surgeon after complaining for five year to my regular surgeon who said the x-ray looked good and I had chronic bursitis. The fourth surgeon put in a figure 8 cable to stabilize the tendons and a plastic in place of the metal liner, also but could not get the tendon close enough to grow scar tissue and attach. The pain is no better, seemingly worse. Any chance a 70 years old can get a better fix and less need of narcotics.
Posted Thu, 3 Oct 2013 in Bones, Muscles and Joints
Answered by Dr. K. Naga Ravi Prasad 1 hour later
Brief Answer:
May be the fixation is not adequate.

Detailed Answer:
Hi, thanks for writing to XXXXXXX

The possible cause of pain in your case could be an inadequate fixation. This is because of the fact that the strong abductor muscles of the hip are attached to the greater trochanter and any amount of loose fixation of the trochanter will make it to move during the activities of daily living. This pull of trochanter will lead to pain.
Non Union is a major problem with trochanteric fractures (especially after a total hip replacement). Generally these injuries are treated with a trochanteric stabilising claw plate, Circlage wiring and adding demineralized bone matrix allograft to achieve successful osseous union.

Another thing to be ruled out in your case is INFECTION. As this is one of the commonest cause of persistent or worsening pain after any form of fixation. A proper blood workup and serial xray films of the involved area or a bone scan will diagnose the condition.

One other possibility to be considered in your case is the stability of the femoral component. A loose femoral component is also one of the causes of persistent pain.

There is no other alternative in your case other than using pain killer medications (depending on the intensity of pain) untill a proper diagnosis is established.

So, a detailed clinical examination and thorough investigations are needed to establish a possible cause of your pain.

I suggest you to approach an orthopedic surgeon with adequate experience in handling revision total hip replacement surgeries for further management.

Hope I have addressed your query. Happy to help further

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