Hip Bursectomy (Trochanteric Bursa Removal): A Complete Guide

Introduction to Hip Bursectomy

If you're struggling with persistent hip pain that hasn’t improved with rest or medication, your doctor may recommend a hip bursectomy. This surgical procedure involves removing the inflamed trochanteric bursa, a small fluid-filled sac near your hip joint that reduces friction between bones and soft tissues.

While the idea of surgery can be intimidating, understanding what a hip bursectomy entails can ease your concerns. This guide will walk you through everything—from why the surgery might be needed to recovery tips—so you can make an informed decision about your treatment.

Hip bursectomies are typically considered when non-surgical treatments fail. The procedure is minimally invasive in many cases, and most patients experience significant pain relief and improved mobility afterward.

What is Trochanteric Bursitis? (Causes & Symptoms)

Trochanteric bursitis is the inflammation of the bursa located on the outer part of the hip (near the greater trochanter of the femur). This condition often causes sharp or aching pain that worsens with movement, prolonged standing, or lying on the affected side.

Common causes include:

• Repetitive stress (running, climbing stairs)
• Hip injuries or trauma
• Poor posture or abnormal gait
• Underlying conditions like arthritis or tendonitis

Symptoms may involve:

• Pain on the outer hip radiating to the thigh
• Tenderness when pressing on the hip
• Stiffness after sitting or sleeping
• Swelling or warmth in severe cases

If conservative treatments (ice, rest, physical therapy) don’t help, a hip bursectomy may be the next step.

When is a Hip Bursectomy Needed? (Indications for Surgery)

Doctors usually recommend a hip bursectomy when:

• Chronic pain persists for 6+ months despite medications, physical therapy, or cortisone injections.
• Mobility is severely limited, affecting daily activities like walking or climbing stairs.
• Imaging tests (MRI/ultrasound) confirm significant bursa thickening or damage.
• Recurrent bursitis flares up repeatedly after non-surgical treatments.

Surgery is typically a last resort after exhausting other options. Your orthopedic surgeon will evaluate your condition and discuss whether a bursectomy is the best solution for you.

Preparing for Hip Bursectomy Surgery

Proper preparation can help ensure a smooth procedure and recovery. Here’s what to expect:

Before Surgery:

• Medical evaluation: Blood tests, X-rays, or an MRI may be required.
• Medication adjustments: You may need to stop blood thinners or NSAIDs temporarily.
• Fasting: No food or drink for 8-12 hours before surgery.

Day of Surgery:

• Wear loose, comfortable clothing.
• Arrange for someone to drive you home.
• The procedure is usually outpatient (no overnight stay).

Your surgeon will provide personalized instructions based on your health and the surgical approach (open vs. arthroscopic).

The Hip Bursectomy Procedure: Step-by-Step

Most hip bursectomies are performed arthroscopically (minimally invasive) under general or regional anesthesia. Here’s a breakdown:

1. Anesthesia: You’ll be sedated to ensure no pain during surgery.
2. Small incisions: The surgeon makes tiny cuts near the hip.
3. Insertion of an arthroscope: A camera guides the removal of the inflamed bursa.
4. Bursa removal: The damaged tissue is carefully excised.
5. Closure: Stitches or steri-strips seal the incisions.

The surgery usually takes 30-60 minutes. In rare cases, an open bursectomy (larger incision) may be needed for severe inflammation.

Recovery & Rehabilitation After Surgery

Recovery varies, but most patients follow this general timeline:

First 1-2 Weeks:

• Rest and limit movement; use crutches if needed.
• Ice the hip to reduce swelling.
• Keep the incision clean and dry.

2-6 Weeks:

• Gradually resume light activities.
• Start physical therapy to restore strength and flexibility.

6+ Weeks:

• Return to normal activities, including low-impact exercise.
• Avoid high-impact sports until cleared by your doctor.

Full recovery may take 3-6 months, depending on your health and adherence to rehab.

Potential Risks & Complications

While hip bursectomy is generally safe, possible risks include:

• Infection: Rare but may require antibiotics.
• Bleeding or blood clots: More common in patients with circulation issues.
• Nerve damage: Temporary numbness or tingling near the incision.
• Recurrence: In rare cases, bursitis may return.

Choosing an experienced surgeon minimizes these risks. Report any unusual symptoms (fever, severe pain) immediately.

Alternatives to Surgery (Non-Surgical Treatments)

Before opting for surgery, consider these conservative approaches:

• Rest & Activity Modification: Avoid movements that aggravate pain.
• Physical Therapy: Strengthens hip muscles and improves alignment.
• Medications: NSAIDs (ibuprofen) or corticosteroid injections reduce inflammation.
• Ice/Heat Therapy: Eases pain and swelling.

If these methods fail after several months, surgery may be the next step.

FAQs About Hip Bursectomy