Hip Bursitis-Bursectomy?

davycrock

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Hi all,
So glad I found this forum. Thought this topic best fit here since it’s a hip issue, but not a replacement, It so hard to find a forum to discuss these topics.
A little about me: I had a major injury in 2011 and part of it involved installation of hardware and a IM rod and screws in my femur, one locking screw at my hip joint area. It was a retrograde procedure, so it’s main incision was at the knee.
I really hope y’all can help!
The injury led to chronic hip bursitis and upon fluoroscopy and MRI there is scar tissue in the ball/socket hip joint. I’ve had 6 hip cortisone injections, about one in every 6-8 months. They provide moderate relief, but i still want to be able to walk and run without chronic pain. I haven’t been able to actually run in 8 years unless it’s right after a injection. I can’t get an OS (orthopedic surgeon) to really want to do a hardware removal. I need more consults too. Generally, they say it might not be possible, or be too traumatic to be worth it as the source pain doesn’t seem to be hardware related -and pain ‘seems’ to be managed with these injections.
Knee bothers too, but less-so than hip. I had 3 screws in knee removed in late 2011 due to pain, and 2 screws broke, so the pieces may be causing residual pain? I’ve also had 3 injections in my knee, in last 2 yrs, which provides relief. In that case, a bursectomy (and a IB procedures maybe) may be the next step-at least for the hip.

What about a bursectomy?

Edit: Do I really need the bursa if it’s constantly inflamed? When the Bursa is really inflamed, I believe I’m feeling the IB ‘clicking’ over the bursa—oooh it’s painful. It seems to me that a endoscopic procedure maybe the next best sequential step if the ‘general interventions of cortisone shots aren’t providing a permanent solution? I just feel the right doc could be great to ream out the scar tissue and remove the bursa, and I hear about this expansion of the Illiotibial Band also? Any help is appreciated. I’m in the Palm Springs area.
 
Last edited:
@davycrock Welcome to BoneSmart. I moved your post to the hip pre-op area. Yes it's not replacement related but sounds like you are considering surgery.

I'm going to tag our medical expert @Josephine for her input on a bursectomy.
 
Hi @davycrock ! Like you, I suffered from hip bursitis for years. Round after round of physio did'nt help at all and cortisone injections only lasted a couple of months. My OS recommended a PRP injection (platelet rich plasma) - this was done over a year ago now and so far it has been a complete success! These injections are most often given to athletes, but are becoming increasingly popular now, although expensive of course. I wouldn't hesitate to recommend this injection - high rates of success and not at all invasive.
 
Do I really need the bursa if it’s constantly inflamed?
You need to read this to learn about the function of bursae Baker's cysts and other knee bursae
Besides which, I've never, ever heard of a bursectomy for bursitis.
I just feel the right doc could be great to ream out the scar tissue and remove the bursa
Never heard of this being done either!
I hear about this expansion of the Illiotibial Band also
Or this. Do you have a link?
 
My OS recommended a PRP injection (platelet rich plasma) - this was done over a year ago now and so far it has been a complete success! ... I wouldn't hesitate to recommend this injection - high rates of success and not at all invasive.
Thank you Linette.
I do recall PRP mentioned by my original OS. So you felt the pain subside rather swiftly?

I’ll have to do my research, as a less invasive measure is ideal. I received a cortisone shot in my knee last week and got a major flare up—I can’t bend it now. I’m scheduled to have a hip cortisone injection in 10 days. I’m seeing a Pain Management doc, so I presume they may not do PRP.
 
Hi Josephine,
@Josephine I was originally pulled into this forum after reading this thread. I’m wondering if I wasn't clear about the issue. My main concern and desire for info is interventions for hip pain.

The hip operation in that thread mentions an endoscopy for removal of hip bursa, and scar tissue and also an extension of iliotibial band. This interested me as it was advised after failed ‘conventional methods’ (cortisone injections, etc.) which pertains to my hip situation.

So now it seems the next best option is a PRP injection?

Re:KNEE My knee (for now) is ok. If I had the hardware removal, it’d probably make the knee worse. As an aside, I’m looking at an arthroscopic-assisted retrograde Intramedullary nail removal option, IF I did explore the hardware removal option, that addresses exactly this...I digress (on the knee).
 
Hi @davycrock Yes, the pain from the bursitis disappeared more or less straight away after the PRP injection. The only downside was that I had to be none weight bearing for 6 weeks ( i.e. on crutches), but in hindsight a small price to pay for losing that bursitis pain.
Good luck with it all @
 
I get you. So has your surgeon checked you out for a hip joint issue?

Other than that, the only way I can help is if you have a copy of your most recent xray I can look at.
 
So has your surgeon checked you out for a hip joint issue?

Other than that, the only way I can help is if you have a copy of your most recent xray I can look at.

@Josephine
Here ya go. This is the best xray that I have right now.

Surgeon and pain doc said the joint itself is OK. There does seem to be arthritis, but didn’t want to try Orthovisc yet.

Any advise from what you see?
Thank you for your help.
-Dave

F5C4FC84-D548-4C9B-8613-A640E70D9F20.jpeg
 
I see some arthritis. The white line here marked here by yellow arrows
I think a replacement is warranted.

davy crock.jpg
 

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