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Trochanteric Branch Femoral Neurectomy as a Novel Adjunct Procedure for Analgesia After Surgical Treatment of Greater Trochanteric Pain Syndrome: A Retrospective Comparative Study

Year: 2026

Type: article

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.

Source: Orthopaedic Journal of Sports Medicine

DOI: 10.1177/23259671261492150

Authors: Nicholas R. Kossoff, Manuel A. Romero-Padron, Joshua S. Everhart

Institutions: Western Michigan University, Indiana University School of Medicine

Language: English

Topic: Anesthesia and Pain Management

Subfield: Anesthesiology and Pain Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,500