Hip Bursectomy (Trochanteric Bursa Removal): What to Expect

Introduction to Hip Bursectomy

If you're struggling with chronic hip pain that hasn’t improved with conservative treatments, a hip bursectomy might be the solution you need. This surgical procedure involves the removal of an inflamed trochanteric bursa—a small, fluid-filled sac that cushions the hip joint. When this bursa becomes irritated due to overuse, injury, or underlying conditions, it can lead to debilitating pain and limited mobility.

In this guide, we’ll walk you through everything you need to know about hip bursectomy, from symptoms that indicate you may need surgery to the recovery process. Whether you're considering this procedure or just exploring options, understanding the process can help you make an informed decision about your hip health.

What is Trochanteric Bursitis? (Causes & Symptoms)

Trochanteric bursitis is a painful condition caused by inflammation of the bursa near the greater trochanter—the bony outer part of your hip. This inflammation often results from repetitive motions, prolonged pressure (like lying on one side), or sudden trauma. Conditions like arthritis, leg-length discrepancies, or muscle imbalances can also contribute.

Common symptoms include:

• Sharp or aching pain on the outer hip, especially when lying on the affected side.
• Stiffness and tenderness when pressing on the hip area.
• Pain that worsens with walking, climbing stairs, or prolonged standing.
• Radiating discomfort down the thigh (mimicking sciatica).

If rest, ice, and anti-inflammatory medications don’t provide relief, your doctor may suggest a hip bursectomy to remove the damaged bursa and restore pain-free movement.

When is a Hip Bursectomy Needed? (Indications)

Not everyone with hip bursitis requires surgery. Doctors typically recommend a hip bursectomy when:

• Conservative treatments fail: If physical therapy, corticosteroid injections, or activity modifications don’t relieve pain after several months.
• Chronic inflammation persists: When the bursa remains swollen and painful despite non-surgical interventions.
• Mobility is severely impacted: If the pain prevents you from walking, sleeping, or performing daily activities.
• Recurrent bursitis occurs: Some patients experience repeated flare-ups, making surgery a more permanent solution.

Your orthopedic surgeon will evaluate your condition through physical exams, imaging (like MRI or ultrasound), and your medical history before recommending surgery. The goal is to restore function and improve quality of life when other options haven’t worked.

Preparing for Hip Bursectomy (Pre-Surgery Steps)

Proper preparation ensures a smoother surgery and recovery. Here’s what to expect:

Medical Evaluation: Your surgeon may order blood tests, imaging scans, or an EKG to assess your overall health.

Medication Adjustments: You might need to stop certain medications (like blood thinners) temporarily.

Pre-Surgery Instructions:

• Fast for 8–12 hours before the procedure if general anesthesia is used.
• Arrange for someone to drive you home post-surgery.
• Set up a recovery space at home with essentials (ice packs, pillows, comfortable clothing).

Physical Prep: Strengthening exercises (as advised by a physiotherapist) can improve post-op recovery. Quitting smoking and eating a balanced diet also promote healing.

The Hip Bursectomy Procedure (Step-by-Step)

A hip bursectomy is typically an outpatient procedure, meaning you can go home the same day. Here’s how it works:

1. Anesthesia: You’ll receive either general anesthesia (putting you to sleep) or local anesthesia with sedation.
2. Incision: The surgeon makes a small incision (about 2–3 inches) over the outer hip.
3. Bursa Removal: The inflamed bursa is carefully dissected and removed.
4. Closure: The incision is closed with sutures or surgical glue, followed by a sterile dressing.

The surgery usually takes 30–60 minutes. Most patients experience minimal bleeding and can walk with assistance shortly afterward. Arthroscopic (minimally invasive) techniques may also be used for faster recovery.

Recovery & Rehabilitation After Surgery

Recovery varies, but most patients follow this general timeline:

First 1–2 Weeks:

• Use crutches or a walker to avoid weight-bearing on the hip.
• Manage pain with prescribed medications and ice packs.
• Keep the incision clean and dry to prevent infection.

Weeks 3–6:

• Gradually resume light activities with your doctor’s approval.
• Start physical therapy to restore strength and flexibility.

6+ Weeks: Most patients return to normal activities, though full recovery may take 3–6 months. Follow-up appointments ensure proper healing.

Potential Risks & Complications

While hip bursectomy is generally safe, possible risks include:

• Infection: Rare but may require antibiotics.
• Bleeding or blood clots: Early movement and compression stockings reduce this risk.
• Nerve damage: Temporary numbness near the incision site.
• Recurrence: In rare cases, bursitis may return.

Choosing an experienced surgeon minimizes complications. Report severe pain, fever, or unusual swelling immediately.

Alternative Treatments to Surgery

Surgery is a last resort. Try these first:

• Physical Therapy: Strengthens hip muscles to reduce bursa stress.
• Medications: NSAIDs (e.g., ibuprofen) or corticosteroid injections.
• Lifestyle Modifications: Avoid repetitive motions; use cushioned seating.
• Shockwave Therapy: Non-invasive sound waves to promote healing.

If these fail after 6–12 months, surgery may be the next step.

FAQs About Hip Bursectomy