Investigation of the Frequency of Greater Trochanteric Pain Syndrome in Patients with Knee Osteoarthritis

Abstract

Objective

Knee osteoarthritis (KOA) and greater trochanteric pain syndrome (GTPS) can co-exist and exacerbate each other’s symptoms. This study aimed to evaluate the frequency of GTPS and the relationship between GTPS and disability, quality of life (QoL) and structural abnormalities, such as varum and valgum, coxa vara and valga, and leg length discrepancy in patients with KOA.

Materials and Methods

This cross-sectional study was conducted with 108 patients between November 2023 and May 2024. Knee, low back, and hip pain severity levels were evaluated using the Visual Analog Scale, KOA grade using the Kellgren-Lawrence (KL) classification, disability using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and QoL using the Short Form-36 (SF-36).

Results

90,7% of the patients were women. The KL grade of KOA was 3 in nearly half of the patients. The frequency of genu varum was very high, at 62%. The frequency of unilateral GTPSwas 33%, and that of bilateral GTPS was 42.6%. The mean scale scores were 50.4±18 for the total WOMAC, 30±25 for the SF-36 general health component, and 48.6±16.0 for the SF-36 mental health component. The presence of genu varum (rho=0.213, p=0.027) and an increase in the KL grade of KOA (rho=0.370, p<0.001) were associated with the development of GTPS.

Conclusions

It was found that GTPS was very common among patients with KOA and that it impaired knee functions and reduced the QoL. According to the results, investigating the presence of GTPS in patients with KOA will facilitate the treatment of KOA, a condition that is challenging, resistant to treatment, and costly to treat.

Zusammenfassung

Hintergrund und Ziel

Gonarthrose und das Trochanter-major-Schmerzsyndrom (TMS) können zusammen auftreten und sich gegenseitig in ihrer Symptomatik verstärken. Ziel der vorliegende Studie war es, die Prävalenz von TMS bei Patientinnen und Patienten mit Gonarthrose zu ermitteln und den Zusammenhang zwischen TMS und funktionellen Einschränkungen, der Lebensqualität sowie strukturellen Abweichungen – wie Genu varum/valgum, Coxa vara/valga und Beinlängendifferenzen – zu analysieren.

Material und Methode

In diese zwischen November 2023 und Mai 2024 durchgeführte Querschnittsstudie wurden insgesamt 108 Patientinnen und Patienten aufgenommen. Die Schmerzintensität im Knie, unteren Rücken und in der Hüfte wurde mittels visueller Analogskala (VAS) erfasst. Der Schweregrad der Gonarthrose wurde anhand der Kellgren-Lawrence-Klassifikation (KL) bewertet. Funktionelle Einschränkungen wurden mit dem Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) und die Lebensqualität mit dem Short Form-36 (SF-36) erhoben.

Ergebnisse

90,7% der Patienten waren Frauen. Bei fast der Hälfte der Teilnehmenden wurde Gonarthrose des KL-Grads 3 diagnostiziert. Mit 62% der Fälle war ein Genu varum ein sehr häufiger Befund. Die Prävalenz von einseitigem TMS betrug 33%, die von beidseitigem TMS 42,6%. Die durchschnittlichen Scores lagen bei 50,4±18 für den WOMAC-Gesamtscore, 30±25 für die SF-36-Komponente zur Allgemeinen Gesundheit und 48,6±16,0 für die Komponente zur Psychischen Gesundheit. Sowohl das Vorliegen von Genu varum (rho=0,213; p=0,027) als auch ein höherer KL-Grad (rho=0,370; p<0,001) waren statistisch signifikant mit dem Auftreten von TMS assoziiert.

Schlussfolgerung

TMS tritt bei Patientinnen und Patienten mit Gonarthrose häufig auf, beeinträchtigt die Kniegelenksfunktion und reduziert die Lebensqualität erheblich. Die gezielte Diagnostik von TMS im Rahmen der Gonarthrosebehandlung könnte zur Optimierung therapeutischer Ansätze bei dieser schwer behandelbaren und kostenintensiven Erkrankung beitragen.

Keywords

knee osteoarthritis - SF-36 - Western Ontario and McMaster Universities Osteoarthritis Index - Kellgren-Lawrence Classification - Greater Trochanteric Pain Syndrome

Schlüsselwörter

Gonarthrose - Trochanter-major-Schmerzsyndrom - Kellgren-Lawrence-Klassifikation - Western Ontario and McMaster Universities Osteoarthritis Index - SF-36

Publication History

Received: 01 July 2025

Accepted after revision: 15 December 2025

Article published online:
04 February 2026

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