PRP

Greater trochanteric pain syndrome

Definition

Chronic lateral trochanteric pain

- abductor tendon tendonitis

- trochanteric bursitis

Epidemiology

Women 40 - 60 years old

Mechanism

? repetitive friction of iliotibial tract over GT

Symptoms

Pain over upper lateral thigh with activity

- often related to hip flexion

Surgical Options

1.  Open antero-lateral approach 

Large / Massive Cuff Tear

2.  Deltopectoral approach

Large Subscapularis tear

3.  Arthroscopic Assisted Mini-open

Indication

- Small / Moderate Cuff Tear < 3cm

- no retraction

Technique

- arthroscopic SAD

Clinical

Pain & Stiffness

- often more pain than FT tears

Bursal side tears more painful than articular

Articular side more common

May see in young patient overhead throwing

Examination

Painful arc

Impingement signs

No weakness

- function good

Definition

Stenosing tenosynovitis of the first dorsal compartment of wrist

Epidemiology

Most are middle aged women

Aetiology

Repetitive thumb movements

- abduction & extension

- combined with RD & UD movements

Any mechanical irritation

- foreign body

- prominent bony surface

- restricted fascial compartment

Definition

Full thickness tear (FTT)

- variable amount retraction from insertion

Partial thickness tear (PTT)

- incomplete

- bursal or articular sided

Definition 

Idiopathic inflammatory condition

- characterised by progressive shoulder pain & stiffness

- due to contracture of capsuloligamentous structures

- spontaneously resolves 

Epidemiology

2% incidence

- 40 - 60 years

- Women 2:1

Sedentary workers

- Non-dominant limb

Bilateral in 10 - 40%

Aetiology

Incidence

Lateral : Medial 9:1

Epidemiology

4th & 5th decades

- M = F

- 75% dominant arm 

50% of regular tennis players

- especially > 2 hrs / week

Aetiology

Insertion pathology / Enthesopathy

Over-extension of the elbow with supination / pronation

Anatomy

Lateral epicondyle

- anconeus from posterior face

- ECRB and EDC from anterior face (CEO)