External snapping hip: a systematic review of outcomes following surgical intervention: External snapping hip systematic review

Pierce, Todd P.; Kurowicki, Jennifer; Issa, Kimona; Festa, Antony; Scillia, Anthony J.; McInerney, Vincent K.

doi:10.1177/1120700018782667

Cited by 20 publications

(21 citation statements)

References 21 publications

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“…A stretching program specific to the ITB and the iliopsoas muscles is indicated, and local corticosteroids injections and physical therapies, as laser therapy and extracorporeal shockwave therapy ESWT, can be useful to manage the pain [ 3 ]. The conservative treatment should be continued for at least 6 months [ 8 ]. Then, if the patient does not respond to a well-conduced conservative program, surgery is indicated.…”

Section: State Of the Current Evidencementioning

confidence: 99%

“…Current literature shows that endoscopic procedures are superior in terms of complication profile, recurrence rate, aesthetic results and patient’s satisfaction [ 4 ]. The most common endoscopic techniques for the treatment of ESHS are diamond-shaped ITB release over the greater trochanter and the release of the femoral insertion of the gluteus maximus tendon [ 5 , 8 , 9 ]. To provide a better comprehension of the different techniques described in literature, we divided the treatment options into two groups according to the surgical approach and strategy: inside–out or outside–in.…”

Section: State Of the Current Evidencementioning

confidence: 99%

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Surgical interventions for external snapping hip syndrome

Randelli

Mazzoleni

Fioruzzi

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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Purpose Snapping hip is a common clinical condition, characterized by an audible or palpable snap of the hip joint. When the snap is perceived at the lateral side of the hip, this condition is known as external snapping hip or lateral coxa saltans, which is usually asymptomatic. Snapping hip syndrome (SHS) refers to a painful snap, which is more common in athletes who require increased hip range of motion. The aim of this article is to review the most common endoscopic techniques for the treatment of ESHS, as well as their results and limitations. Methods This is a review of the current literature of endoscopic surgical procedures and of the results of the treatment of external snapping hip syndrome. Results The pathogenesis of SHS is mechanical. The initial treatment attempt is conservative, and usually provides good results. Patients who do not respond to conservative management are candidate for surgery. The endoscopic release of the ilio-tibial band or the endoscopic release of the femoral insertion of the gluteus maximum tendon is the most popular technique. Conclusion Endoscopic techniques provide fewer complications compared to open surgery, a lower recurrence rate and good clinical outcomes. More comparative studies with a longer follow-up are required to adequate evaluate the full role of endoscopic techniques in periarticular hip surgery. Level of evidence Level V.

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Section: State Of the Current Evidencementioning

confidence: 99%

Section: State Of the Current Evidencementioning

confidence: 99%

Surgical interventions for external snapping hip syndrome

Randelli

Mazzoleni

Fioruzzi

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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“…They include lengthening, 12 mostly by Z‐plasty, 13–16 release, 9,11 partial resection, 17,18 and sectioning 10 of the ITB. These procedures, all performed under general anesthesia, provide similar results, but a significant recurrence rate of up to 29% has been shown 19,20 . Indeed, snapping hip is an active phenomenon that cannot be tested intraoperatively under general anesthesia.…”

mentioning

confidence: 98%

Ultrasound‐Guided Percutaneous Iliotibial Band Release for External Coxa Saltans

Coulomb

Cascales

Marès

et al. 2020

J of Ultrasound Medicine

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The surgical treatment of external coxa saltans is not standardized. Many techniques for iliotibial release have been described, both open and arthroscopic. No technique describes ultrasound release. In this cadaveric study, we describe a minimally invasive technique for percutaneous iliotibial release with ultrasound guidance, designed to be performed under local anesthesia. The future objective would be to perform an active intraoperative test of the snapping hip to confirm adequate release, thus reducing the risk of recurrence.

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“…As external snapping hip is the most common form of palpable or auditory movement around the hip joints [21], and an often-encountered reason for patients to present in the outpatient clinic, there is an increased interest in sports medicine research to further investigate the aetiology and treatment approach of this condition [22][23][24]. It was therefore the purpose of this retrospective regression analysis to look for predisposing bony morphological factors that may lead to developing the current condition, as there are no studies to our knowledge that investigated that.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, an escalation with an ultrasound-guided corticosteroid injection can be considered for a quick pain relief [32] to enable patients to undergo physical therapy [33]. Despite all the above-mentioned efforts, surgical treatment may be necessary when conservative treatment and corticosteroid injection fail [22]. Surgical interventions aim at lengthening of the iliotibial band.…”

Section: Discussionmentioning

confidence: 99%

External snapping hip syndrome is associated with an increased femoral offset

Andronic

Rahm

Singh

et al. 2021

Eur J Orthop Surg Traumatol

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Background External snapping hip syndrome (ESH) is postulated to be one of the causes of greater trochanteric pain syndrome, which also includes greater trochanteric bursitis and tendinopathy or tears of the hip abductor mechanism. However, it was not yet described what kind of bony morphology can cause the snapping and whether symptomatic and asymptomatic individuals have different imaging features. Purpose It was the purpose of this study to look for predisposing morphological factors for ESH and to differentiate between painful and asymptomatic snapping. Methods A consecutive cohort with ESH and available magnetic resonance imaging (MRI) between 2014 and 2019 was identified. The control group consisted of patients that underwent corrective osteotomies around the knee for mechanical axis correction and never complained of hip symptoms nor had undergone previous hip procedures. The following parameters were blindly assessed for determination of risk factors for ESH: CCD (corpus collum diaphysis) angle; femoral and global offset; femoral antetorsion; functional femoral antetorsion; translation of the greater trochanter (GT); posterior tilt of the GT; pelvic width/anterior pelvic length; intertrochanteric width. Hip and pelvic offset indexes were calculated as ratios of femoral/global offset and intertrochanteric/pelvic width, respectively. For the comparison of symptomatic and asymptomatic snapping, the following soft-tissue signs were investigated: presence of trochanteric bursitis or gluteal tendinopathy; presence of surface bony irregularities on trochanter major and ITB (Iliotibial band) thickness. Results A total of 31 hips with ESH were identified. The control group (n = 29) consisted of patients matched on both age (± 1) and gender. Multiple regression analysis determined an increased hip offset index to be independent predictor of ESH (r = + 0.283, p = 0.025), most likely due to the higher femoral offset in the ESH group (p = 0.031). Pearson correlation analysis could not identify any significant secondary factors. No differences were found between painful and asymptomatic snapping on MRI. Conclusions A high hip offset index was found as an independent predictor for external snapping hip in our cohort, mainly due to increased femoral offset. No imaging soft-tissue related differences could be outlined between symptomatic and asymptomatic external snapping. Level of evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00590.

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External snapping hip: a systematic review of outcomes following surgical intervention: External snapping hip systematic review

Cited by 20 publications

References 21 publications

Surgical interventions for external snapping hip syndrome

Surgical interventions for external snapping hip syndrome

Ultrasound‐Guided Percutaneous Iliotibial Band Release for External Coxa Saltans

External snapping hip syndrome is associated with an increased femoral offset

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