Platelet-Rich Plasma Injections for Refractory Greater Trochanteric Bursitis: A Three-Patient Case Series

Greater trochanteric bursitis is a common cause of lateral hip pain and is frequently considered within the broader clinical spectrum of greater trochanteric pain syndrome. Initial treatment commonly includes activity modification, physical therapy, a home exercise program, nonsteroidal anti-inflammatory drugs, and other nonopioid medications. Corticosteroid injections may provide meaningful relief, although their duration of benefit can be limited. Platelet-rich plasma is an autologous biologic injectate that can be considered as an alternative treatment for greater trochanteric pain syndrome.

We present three patients with clinically diagnosed greater trochanteric bursitis who underwent fluoroscopically guided platelet-rich plasma injections after failing conservative treatment options. The first patient was a woman in her 50s with left greater trochanteric bursitis who had failed physical therapy, a home exercise program, nonsteroidal anti-inflammatory drugs, and muscle relaxants. Two previous corticosteroid injections provided approximately two months and three weeks of relief, respectively. Following a platelet-rich plasma injection into the left greater trochanteric bursa, she reported 50% sustained pain relief at three-month follow-up. The second patient was a woman in her 40s with bilateral greater trochanteric bursitis who had failed physical therapy, a home exercise program, nonsteroidal anti-inflammatory drugs, and duloxetine. A previous corticosteroid injection provided only one week of relief. Following bilateral fluoroscopically guided platelet-rich plasma injections, she reported 70% sustained pain relief at six-week follow-up. The third patient was a man in his 50s with left greater trochanteric bursitis diagnosed clinically and supported by magnetic resonance imaging. He had failed physical therapy, a home exercise program, and nonsteroidal anti-inflammatory drugs and was not interested in corticosteroid injections. An initial platelet-rich plasma injection provided 25% improvement at four-week follow-up. A second injection was performed two weeks later, after which he reported 85% sustained pain relief at three-month follow-up. No complications were reported in any patient.

Fluoroscopically guided platelet-rich plasma injections were associated with clinically meaningful pain improvement in three patients with refractory greater trochanteric bursitis. Two patients experienced moderate improvement after a single treatment, while one patient demonstrated a substantially greater response following a second injection. These cases suggest that platelet-rich plasma may be considered in carefully selected patients who have experienced limited benefit from corticosteroid injections or wish to avoid corticosteroid exposure.