Browsing by Subject "Greater Trochanteric Pain Syndrome"
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Item ANATOMICAL VARIABILITY OF GLUTEUS MAXIMUS TENDON(2013-04-12) Taylor, VictorPurpose: As part of a series of dissections geared towards an improved anatomical understanding of Greater Trochanteric Pain Syndrome, it was observed that there were multiple tendons from the gluteus maximus inserting on the femur. In this study, the variability of the gluteus maximus tendon insertion was examined. Methods: The experiment was done on 40 partially dissected, embalmed bodies that were donated through the Willed Body Program at the University of North Texas Health Science Center. The gluteus maximus muscle belly was detached from the iliac crest. In addition, the iliotibial band was cut from the origin (ilium) and reflected to gain access to the gluteus maximus tendon. The fat in the area around the greater trochanter was cleaned until the tendon of the gluteus maximus was revealed. Results: 22 hips had only one tendon from the gluteus maximus inserting on the femur (13 on the right and 9 on the left), 19 hips had 2 tendons inserting (10 on the right and 9 on the left), 7 with 3 insertions (5 on the right and 2 on the left), and 1 with 4 insertions on the left side. When sex was separated, women had more insertions with 2 tendons than insertions with 1 tendon. Conclusions: It has been shown that there are multiple tendons from the gluteus maximus inserting into the femur.Item CHANGE IN FORCE BETWEEN ILIOTIBIAL BAND CUT AND GLUTEUS MAXIMUS TENDON CUT(2014-03) Taylor, Victor W. II; Reeves, Rustin E.; Belmares, Ricardo; Guttmann, Geoffrey; Wood, Addison; Crofford, TheodoreIntroduction: Greater Trochanteric Pain Syndrome (GTPS) is a hip pain due to repeated trauma to bursa on the greater trochanter. Surgical procedure cut the iliotibial band (IT band) in order to relieve the pressure around the greater trochanter. However, the IT band may not be the primary cause of GTPS. It is hypothesized the tendon of the gluteus maximus (gmax) tendon is the primary cause of GTPS. Materials: Force sensor test on the greater trochanter was performed on fresh cadavers. Cadavers were stabilized by the hip on a gurney. The skin on the top half of the thigh is reflected and cleans to expose the iliotibial band (IT band). Incision is made between the IT band and tensor fascia lata, and a force sensor from Tekscan was placed on the greater trochanter. Three measurements were done: Normal, IT cut, and gmax cut. Measurements will be made from 0o to 20o flexion and extension in increments of 10o three times, each at a fixed 0o, 10o, and 15o adduction. SPSS was used for statistical calculation. Summary: 6 hips (3 cadavers) were observed. There were no significance between normal and IT cut, as well as, between the normal and gmax cut. There were significant difference between gmax and IT cut at 0o adduction (p=.03) and 0o adduction, 10o flexion (p=.01). Conclusion: This study will help to develop new treatment approach to GTPS. More data will be collected in the future.Item Contrasting Force Reduction at the Greater Trochanter Using Different Surgical Procedures for Relief of Greater Trochanteric Pain Syndrome(2014-08-01) Taylor II, Victor W.; Rustin Reeves; Claire Kirchhoff; Geoffrey GuttmannGreater Trochanteric Pain Syndrome (GTPS) is associated with hip pain from repeated trauma to the greater trochanter bursa. Surgical procedures cut the iliotibial tract (ITT) in order to relieve the pressure on the greater trochanter. We propose the ITT may not be the primary cause of GTPS. In this study, I hypothesize that in addition to the ITT, the tendon of the gluteus maximus (GMax) also exerts force on the greater trochanter. Force measurement tests were performed on fresh cadavers donated to the University of North Texas Health Science Center. In addition, an anatomical study of the hip was performed on partially dissected embalmed cadavers to better describe the GMax tendon and ITT insertion at the greater trochanter. In the anatomical study, fibers from the ITT were observed comingling with the GMax tendon to insert at the gluteal tuberosity. Multiple variation of the GMax tendon were observed, some presenting with three or four tendinous slips. In this study, 157 hips were examined. 63 hips (40%) had only one tendinous slip, 57 hips (36%) had 2 tendinous slips, 34 (22%) had 3 slips, and only 3 (2%) were observed with 4 tendinous slips. One unique variation was found during the course of this study and was submitted for publication. To measure the force exerted by the ITT at the greater trochanter, six unembalmed cadavers were used to contrast the effects of different surgical approaches used for force reduction. Force measurements were first taken for normal ITT (no cuts) and then for one of two types of ITT incisions on one hip. Next, force measurements were taken for a normal ITT and then after the GMax tendon was transected on the contralateral hip. Overall, both surgical approaches showed a strong trend in reducing force at the greater trochanter as the hip was subjected to a range of specified movements. Even though a significant force reduction occurred with transection of the GMax tendon, making this procedure a potential new treatment for GTPS, the depth of the structure in the gluteal region might prove impractical as a practical surgical approach.