Surgical interventions for external snapping hip syndrome

Abstract

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.

Endoscopic Treatment of Recurred External Snapping Hip After Endoscopic Iliotibial Band Release

“…The most common endoscopic techniques for the treatment of external snapping hip syndrome are diamond-shaped iliotibial band release over the greater trochanter and the release of the femoral insertion of the gluteus maximus tendon. 3,6 This reported technique basically follows the same approaches. Besides endoscopic release of the iliotibial band and gluteus maximus tendon, the fibrous band underneath the iliotibial band is also released.…”

“…1,[3][4][5] The endoscopic release of the iliotibial band or the endoscopic release of the femoral insertion of the gluteus maximus tendon is the most popular technique. 4,6 Endoscopic techniques, as compared to open surgery, provide fewer complications, lower recurrence rate, and good clinical outcomes. 6 However, there still is a recurrence rate of 7-29%.…”

“…4,6 Endoscopic techniques, as compared to open surgery, provide fewer complications, lower recurrence rate, and good clinical outcomes. 6 However, there still is a recurrence rate of 7-29%. 2,7 Although recurrence is often painless, revision surgery may be indicated for symptomatic recurrence.…”

Snapping Hip Syndrome: A Comprehensive Update

“…38 While the Polesello technique spares deformity of the lateral thigh, residual gluteal hypotrophy and asymmetry have been reported in a few studies using the Polesello technique. 42 For endoscopic release, Malinowski et al described a fanlike technique that allows the surgeon to gradually incise structures intraoperatively until snapping is eliminated. 43 The aim is to avoid total release and tissue removal, except in the case of an inflamed trochanteric bursa.…”

“…However, in comparing open to endoscopic surgical management, it is essential to note the limited sample size for endoscopic surgeries. 42,[53][54][55] EXTERNAL SNAPPING HIP SYNDROME Open surgical management of external SHS primarily targets the iliotibial band to prevent sliding over the greater trochanter. Various open surgical procedures have been described, including resection of the iliotibial band and lengthening of the iliotibial band (Z-plasty).…”