Trochanteric Branch Femoral Neurectomy as a Novel Adjunct Procedure for Analgesia After Surgical Treatment of Greater Trochanteric Pain Syndrome: A Retrospective Comparative Study
- 1Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan, USA
- 2Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
Abstract
Background: The trochanteric branch of the femoral nerve provides sensory innervation to the peritrochanteric region, yet its role in postoperative pain modulation remains underexplored. Purpose: To determine the association between trochanteric branch femoral neurectomy (TBFN), a novel analgesic procedure, and early postoperative pain control for patients who undergo surgical treatment of greater trochanteric pain syndrome in an outpatient surgery setting. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review was conducted on 271 patients who underwent outpatient gluteus medius repair and/or iliotibial band lengthening by a single surgeon (J.S.E.) between October 2021 and December 2025. Patients were divided into 2 cohorts: those with concomitant TBFN and those without. TBFN was performed in all patients after September 2024, whereas all patients before September 2024 underwent surgery without TBFN. Primary outcomes evaluated included total time in the postanesthesia care unit (PACU) and opioid medication requirements (converted to morphine milligram equivalents [MME]) in PACU before discharge. Secondary outcomes assessed included adjunct analgesic use (nonsteroidal anti-inflammatory drugs, benzodiazepines). Multivariable regression was used to determine the relationship between TBFN and outcomes, adjusting for age, sex, body mass index, and tobacco use. Results: A total of 132 patients were in the TBFN group, compared with 139 controls. The median age was 60.1 years (interquartile range, 48.2-69.6), with 85% females. Median PACU times were shorter with TBFN compared with controls (69 vs 81 minutes; P = .007). On multivariable analysis, TBFN was independently associated with reduced PACU duration (β = 3.36; SE = 1.65; P = .04), while tobacco use was associated with longer PACU times (β = 3.49; SE = 1.76; P = .049). Opioid administration in PACU did not differ between groups (median 15 MME for both groups; P = .91), with or without adjustment for confounding factors. However, the use of adjunct analgesics in PACU was lower with TBFN than controls (0% vs 10%; P < .001). Conclusion: Trochanteric branch femoral neurectomy is a novel adjunct to surgical treatment of greater trochanteric pain syndrome and gluteus medius tears that was associated with a modest reduction in PACU duration. Further prospective research incorporating direct measures of postoperative pain and longer-term clinical outcomes is necessary to determine the analgesic efficacy and safety of this procedure. Clinical Relevance: TBFN is a simple adjunct procedure that can be performed during lateral hip surgery and is associated with shorter PACU recovery time and reduced need for adjunct analgesia. TBFN may improve early postoperative pain control, enhance the efficiency of ambulatory surgery, and reduce reliance on additional medications.
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BibTeX
@article{kossoff2026trochanteric,
title = {{Trochanteric Branch Femoral Neurectomy as a Novel Adjunct Procedure for Analgesia After Surgical Treatment of Greater Trochanteric Pain Syndrome: A Retrospective Comparative Study}},
author = {Nicholas R. Kossoff BS and Manuel A. Romero-Padron MD and Joshua S. Everhart MD, MPH},
journal = {Orthopaedic Journal of Sports Medicine},
year = {2026},
month = oct,
doi = {10.1177/23259671261492150},
url = {https://doi.org/10.1177/23259671261492150},
note = {CC BY},
}
RIS
TY - JOUR
TI - Trochanteric Branch Femoral Neurectomy as a Novel Adjunct Procedure for Analgesia After Surgical Treatment of Greater Trochanteric Pain Syndrome: A Retrospective Comparative Study
AU - Nicholas R. Kossoff BS
AU - Manuel A. Romero-Padron MD
AU - Joshua S. Everhart MD, MPH
PY - 2026
DA - 2026/10/23
JO - Orthopaedic Journal of Sports Medicine
DO - 10.1177/23259671261492150
UR - https://doi.org/10.1177/23259671261492150
AB - Background: The trochanteric branch of the femoral nerve provides sensory innervation to the peritrochanteric region, yet its role in postoperative pain modulation remains underexplored. Purpose: To determine the association between trochanteric branch femoral neurectomy (TBFN), a novel analgesic procedure, and early postoperative pain control for patients who undergo surgical treatment of greater trochanteric pain syndrome in an outpatient surgery setting. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review was conducted on 271 patients who underwent outpatient gluteus medius repair and/or iliotibial band lengthening by a single surgeon (J.S.E.) between October 2021 and December 2025. Patients were divided into 2 cohorts: those with concomitant TBFN and those without. TBFN was performed in all patients after September 2024, whereas all patients before September 2024 underwent surgery without TBFN. Primary outcomes evaluated included total time in the postanesthesia care unit (PACU) and opioid medication requirements (converted to morphine milligram equivalents [MME]) in PACU before discharge. Secondary outcomes assessed included adjunct analgesic use (nonsteroidal anti-inflammatory drugs, benzodiazepines). Multivariable regression was used to determine the relationship between TBFN and outcomes, adjusting for age, sex, body mass index, and tobacco use. Results: A total of 132 patients were in the TBFN group, compared with 139 controls. The median age was 60.1 years (interquartile range, 48.2-69.6), with 85% females. Median PACU times were shorter with TBFN compared with controls (69 vs 81 minutes; P = .007). On multivariable analysis, TBFN was independently associated with reduced PACU duration (β = 3.36; SE = 1.65; P = .04), while tobacco use was associated with longer PACU times (β = 3.49; SE = 1.76; P = .049). Opioid administration in PACU did not differ between groups (median 15 MME for both groups; P = .91), with or without adjustment for confounding factors. However, the use of adjunct analgesics in PACU was lower with TBFN than controls (0% vs 10%; P < .001). Conclusion: Trochanteric branch femoral neurectomy is a novel adjunct to surgical treatment of greater trochanteric pain syndrome and gluteus medius tears that was associated with a modest reduction in PACU duration. Further prospective research incorporating direct measures of postoperative pain and longer-term clinical outcomes is necessary to determine the analgesic efficacy and safety of this procedure. Clinical Relevance: TBFN is a simple adjunct procedure that can be performed during lateral hip surgery and is associated with shorter PACU recovery time and reduced need for adjunct analgesia. TBFN may improve early postoperative pain control, enhance the efficiency of ambulatory surgery, and reduce reliance on additional medications.
SN - 2325-9671
ER -