Greater Trochanteric Pain Syndrome (GTPS) is a frustrating causes of chronic hip pain—especially for women and middle-aged adults. Often misdiagnosed and challenging to treat, GTPS affects mobility, daily comfort, and quality of life.

That’s exactly what researchers set out to discover in a systematic literature review on Platelet-Rich Plasma (PRP) therapy for GTPS—and the results are giving new hope to patients and clinicians alike.

What is Greater Trochanteric Pain Syndrome (GTPS)?

GTPS, sometimes called trochanteric bursitis, refers to pain over the outer part of the hip. It’s often caused not by inflammation of the bursa (as once believed), but by gluteal tendinopathy—chronic wear-and-tear of the gluteus medius and minimus tendons [Long et al, 2013; Grimaldi et al, 2015].

GTPS is common, particularly in middle-aged women, runners, and individuals with low back or knee issues. And while most cases improve with physical therapy and anti-inflammatory medications, chronic GTPS can be stubborn, requiring more advanced treatments like corticosteroid injections, shockwave therapy—or now, PRP [Long et al, 2013; Grimaldi et al, 2015].

The condition is often misdiagnosed as bursitis, but imaging studies, such as ultrasound and MRI, have shown that gluteal tendinopathy is the primary pathology in most cases [Kong et al, 2007; Long et al, 2013].

What is PRP and How Does it Work?

Platelet-Rich Plasma (PRP) is a regenerative therapy made from a small sample of your own blood. After spinning it in a centrifuge to concentrate the platelets, the resulting solution is injected into the damaged tissue.

Why platelets? They’re packed with growth factors—which are essential for the healing process [Sheean et al, 2021; Dos Santos et al, 2021].

These factors promote cellular proliferation, migration, and differentiation, which are critical for tissue regeneration. For instance, PRP has been shown to enhance the healing of tendons, ligaments, and muscles by increasing collagen production, cellularity, and vascularity [Chalidis et al, 2023; Etulain, 2018].

PRP has already shown promise for:

• Tennis elbow
• Rotator cuff injuries
• Knee osteoarthritis
• Achilles tendinopathy

The Review: What the Research Says About PRP for GTPS

The review by Ali et al., published in the Journal of Hip Preservation Surgery, analyzed nine studies on PRP for GTPS, including:

• 3 Randomized Controlled Trials (RCTs)
• 2 case series
• 4 conference abstracts

In total, 209 patients were studied—mostly women, with a mean age of 58—and all had symptoms lasting longer than 3 months.

• The study found:
  • Improvement was typically seen within 3 months after PRP injection.
  • Benefits often lasted up to 12 months or more in follow-ups.
  • PRP appeared to be more effective than corticosteroids in some studies—especially over the long term.
  • Side effects were minimal, and PRP was considered safe.

What’s Working and What’s Not? What do the Studies in this Review Teach Us:

• Fitzpatrick et al. (2018)
  • Design: Double-blind RCT
  • PRP vs. Corticosteroids
  • At 12 weeks, PRP patients had significantly greater pain and function improvement
  • 82% of PRP patients met the threshold for meaningful improvement vs. 56.7% with steroids

• Ribeiro et al. (2016)
  • No significant difference between PRP and corticosteroid groups at 2 months
  • Suggests PRP may require more time to show benefits

• Jacobson et al. (2016)
  • Compared PRP to tendon fenestration (dry needling)
  • Both showed improvements, but no clear winner

• Lee et al. (2016)
  • Case series with 21 patients
  • PRP plus tenotomy led to clinically significant improvements across multiple outcome scores
  • Results sustained for up to 19.7 months

Does PRP Actually Work for GTPS?

YES, This systematic review shows most studies report reduced pain, improved function, and longer-lasting benefits compared to corticosteroids.

The research still lacks:

• Large, high-quality trials
• Standardized PRP formulations (every study used different prep methods)
• Consistent injection protocols

Why Cortisone Might Not Be the Long-Term Solution

Corticosteroid injections are commonly used for short-term relief of GTPS, but:

• Effects wear off within 3–6 months
  • A randomized controlled trial demonstrated that CSI provided significant pain relief and functional improvement at 3 months compared to usual care, but these benefits were not sustained at 12 months. Another study found that CSI led to significant pain reduction and functional improvement at 1, 3, and 6 months, although the effect diminished over time. A double-blind placebo-controlled trial indicated no significant long-term benefit of CSI over placebo [Park et al, 2016; Nissen et al, 2019; Brinks et al, 2011].
• Repeated use can weaken tendons and soft tissue
  • Repeated corticosteroid injections have been associated with potential adverse effects, including tendon weakening and soft tissue damage, as noted in the literature [Nissen et al, 2019; Brinks et al, 2011].
• Not ideal for chronic tendinopathy
  • CSI may not be ideal for chronic tendinopathy due to the lack of sustained long-term benefits and potential adverse effects [Nissen et al, 2019].

While they often provide quick pain relief, multiple studies show no long term benefit. PRP, on the other hand, aims to repair the tissue—not just mask the pain.

The Pros of PRP for GTPS

• Uses your own blood—no foreign substances
• Minimally invasive and done in-office
• Targets the root cause (tendon degeneration)
• Low risk of side effects
• Does not have the negative effects of steroids

Things to Consider Before Trying PRP

• Not all PRP is the same. Ask your provider what system they use—and if their PRP system is designed to get a "dose" of platelets appropriate for this condition.
• Is the injection guided? Make sure that the provider is skilled in ultrasound guided injections. Are the accredited by the AIUM for these procedures? Check here
• It’s not a miracle cure. PRP may take several weeks to months to show full benefits.
• Insurance may not cover it.
  

Who Should Consider PRP?

You may be a candidate for PRP if:

• You’ve had hip pain for 3+ months
• Imaging (like diagnostic ultrasound or MRI) confirms gluteal tendinopathy
• You’ve tried conservative management - physical therapy, NSAIDs, or steroids - with little improvement
• You’re looking for a non-surgical option

PRP for Greater Trochanteric Pain Syndrome appears to be safe, minimally invasive, and backed by early clinical success. While not yet a universal standard, it offers a viable option for patients who’ve exhausted other treatments.

If you’ve been struggling with GTPS and haven’t found lasting relief, PRP could be worth exploring. Learn more at:

(781) 591-7855

info@BSBortho.com

20 Walnut St

Suite 14

Wellesley MA 02481

Reference:

• Ali M, Oderuth E, Atchia I, Malviya A. The use of platelet-rich plasma in the treatment of greater trochanteric pain syndrome: a systematic literature review. J Hip Preserv Surg. 2018 Aug 30;5(3):209-219.
  
• Brinks, A., van Rijn, R. M., Willemsen, S. P., Bohnen, A. M., Verhaar, J. A., Koes, B. W., & Bierma-Zeinstra, S. M. (2011). Corticosteroid injections for greater trochanteric pain syndrome: a randomized controlled trial in primary care. Annals of family medicine, 9(3), 226–234.
  
• Chalidis, B., Givissis, P., Papadopoulos, P., & Pitsilos, C. (2023). Molecular and Biologic Effects of Platelet-Rich Plasma (PRP) in Ligament and Tendon Healing and Regeneration: A Systematic Review. International journal of molecular sciences, 24(3), 2744.
• Dos Santos, R. G., Santos, G. S., Alkass, N., Chiesa, T. L., Azzini, G. O., da Fonseca, L. F., Dos Santos, A. F., Rodrigues, B. L., Mosaner, T., & Lana, J. F. (2021). The regenerative mechanisms of platelet-rich plasma: A review. Cytokine, 144, 155560.
• Etulain J. (2018). Platelets in wound healing and regenerative medicine. Platelets, 29(6), 556–568.
• Fitzpatrick, J., Bulsara, M. K., O'Donnell, J., McCrory, P. R., & Zheng, M. H. (2018). The Effectiveness of Platelet-Rich Plasma Injections in Gluteal Tendinopathy: A Randomized, Double-Blind Controlled Trial Comparing a Single Platelet-Rich Plasma Injection With a Single Corticosteroid Injection. The American journal of sports medicine, 46(4), 933–939.
• Grimaldi, A., Mellor, R., Hodges, P., Bennell, K., Wajswelner, H., & Vicenzino, B. (2015). Gluteal Tendinopathy: A Review of Mechanisms, Assessment and Management. Sports medicine (Auckland, N.Z.), 45(8), 1107–1119.
• Jacobson, J. A., Yablon, C. M., Henning, P. T., Kazmers, I. S., Urquhart, A., Hallstrom, B., Bedi, A., & Parameswaran, A. (2016). Greater Trochanteric Pain Syndrome: Percutaneous Tendon Fenestration Versus Platelet-Rich Plasma Injection for Treatment of Gluteal Tendinosis. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine, 35(11), 2413–2420.
• Kong, A., Van der Vliet, A., & Zadow, S. (2007). MRI and US of gluteal tendinopathy in greater trochanteric pain syndrome. European radiology, 17(7), 1772–1783.
  
• Lee, J. J., Harrison, J. R., Boachie-Adjei, K., Vargas, E., & Moley, P. J. (2016). Platelet-Rich Plasma Injections With Needle Tenotomy for Gluteus Medius Tendinopathy: A Registry Study With Prospective Follow-up. Orthopaedic journal of sports medicine, 4(11), 2325967116671692.
  
• Long, S. S., Surrey, D. E., & Nazarian, L. N. (2013). Sonography of greater trochanteric pain syndrome and the rarity of primary bursitis. AJR. American journal of roentgenology, 201(5), 1083–1086.
• Nissen, M. J., Brulhart, L., Faundez, A., Finckh, A., Courvoisier, D. S., & Genevay, S. (2019). Glucocorticoid injections for greater trochanteric pain syndrome: a randomised double-blind placebo-controlled (GLUTEAL) trial. Clinical rheumatology, 38(3), 647–655.
  
• Park, K. D., Lee, W. Y., Lee, J., Park, M. H., Ahn, J. K., & Park, Y. (2016). Factors Associated with the Outcome of Ultrasound-Guided Trochanteric Bursa Injection in Greater Trochanteric Pain Syndrome: A Retrospective Cohort Study. Pain physician, 19(4), E547–E557.
• Ribeiro, A. G., Ricioli, W., Junior, Silva, A. R., Polesello, G. C., & Guimarães, R. P. (2016). PRP IN THE TREATMENT OF TROCHANTERIC SYNDROME: A PILOT STUDY. Acta ortopedica brasileira, 24(4), 208–212.
  
• Sheean, A. J., Anz, A. W., & Bradley, J. P. (2021). Platelet Rich Plasma: Fundamentals and Clinical Applications. Arthroscopy. 37(9), 2732–2734.