Mid- to long-term clinical outcomes of arthroscopic surgery for external snapping hip syndrome

Abstract

This study evaluated the outcomes of arthroscopic surgery for the treatment of external snapping hip at 2- to 10-year follow-ups. Eighteen patients with refractory external snapping hip treated by arthroscopic surgery were enrolled in this prospective study. All patients underwent unsuccessful conservative treatment for more than 3 months before surgery. We made diamond-shaped defects on the iliotibial band and resected peripheral fibrosis tissues for iliotibial band release with an arthroscopic approach. The visual analog scale (VAS), modified Harris hip score and return to previous level of activity were evaluated as functional outcomes. In addition, residual discomfort or the presentation of complications was also investigated. The average follow up period was 7 years. The modified Harris hip score increased from 70.08 preoperatively to 93.14 postoperatively, and the VAS score decreased from 3.67 preoperatively to 1.17 2 weeks after the operation and declined to 0.33 at the last follow-up. Neither recurrence of snaps nor complications were recorded. Two patients complained of a tight sensation with tenderness after exertion. Our clinical outcomes were compatible with those of previous studies, and no long-term complications were noted, even with a relatively longer follow-up period than what was reported in previous studies. Arthroscopic surgery is a safe and effective treatment that can provide promising long-term clinical outcomes for patients with refractory external snapping hip.

Clinical Outcomes Following Incomplete Arthroscopic Iliotibial Band Release for External Snapping Hip Syndrome: An Observational Study

“…There was increased functional score, and neither recurrence of snaps nor complications were recorded. However, there was no mention for incomplete arthroscopic release 15 . Zhang et al .…”

“…However, there was no mention for incomplete arthroscopic release. 15 Zhang et al . reported outstanding results of their three‐step arthroscopic release procedure for failed primary open gluteal muscle contracture release.…”

“…However, there was no mention for incomplete arthroscopic release. 15 Zhang et al reported outstanding results of their three-step arthroscopic release procedure for failed primary open gluteal muscle contracture release. 8 They evaluated 136 cases of arthroscopic release as a solution for failed open gluteal muscle contracture release for revision surgery.…”

A percutaneous ultrasound-guided iliotibial band release technique reduces surgical time and costs compared to an endoscopic technique

“…The failure rate of endoscopic techniques is 13%, with recurrence of the snapping but without pain [7, 23]. In an open surgery series, adherent and painful scars were reported by 1/3 patients, needing 2–6 months physiotherapy with a partial response to desensitization [3]. It seems to be a benefit of endoscopic techniques compared to open procedures, while it has never been done in a clinical trial, yet with a high rate of failure [18].…”

“…Surgical treatment is indicated for painful ESH in case of a 6 months of conservative treatment failure. Many techniques have been described [15], first open surgery including lengthening mostly by Z‐plasty, and partial resection of the ITB [3]. More recently, three endoscopic techniques have been described involving transversal section of the ITB [23], creation of a diamond‐shaped window through the ITB over the G [7] and release of the distal femoral insertion of the gluteus maximus muscle [13].…”