Hip Pelvis.  2014 Sep;26(3):173-177. 10.5371/hp.2014.26.3.173.

Arthroscopic Treatment for External Snapping Hip

• Yoon JY
• Kwak HS
• Yoon KS
• Chang JS
• Yoon PW

• KMID: 2054181
• DOI: http://doi.org/10.5371/hp.2014.26.3.173

Abstract

PURPOSE
The purpose of this study was to evaluate the clinical outcome of arthroscopic treatment for recalcitrant external snapping hip.
MATERIALS AND METHODS
Between September 2011 and June 2013, we evaluated 7 patients (10 cases) with snapping hip who were refractory to conservative treatments for at least 3 months. Two patients (4 cases) were impossible to adduct both knees in 90degreesof hip flexion. Surgery was done in lateral decubitus position, under spinal anesthesia. We made 2 arthroscopic portals to operate the patients, and used cross-cutting with flap resection technique to treat the lesion. We performed additional gluteal sling release in those 2 patients (4 cases) with adduction difficulty. Average follow-up length was 19 months (range, 12-33 months). Clinical improvement was evaluated with visual analog scale (VAS), modified Harris hip score (mHHS), and also investigated for presence of limping or other complications as well.
RESULTS
The VAS decreased from 6.8 (range, 6-9) preoperatively to 0.2 (range, 0-2) postoperatively, and the mHHS improved from 68.2 to 94.8 after surgery. None of the patients complained of post-operative wound problem or surgical complications.
CONCLUSION
The clinical outcome of arthroscopic treatment for recalcitrant external snapping hip was encouraging and all patients were also satisfied with the cosmetic results.

Keyword

External snapping hip; Arthroscopy; Iliotibial band release; Gluteal sling release

MeSH Terms

Anesthesia, Spinal
Arthroscopy
Follow-Up Studies
Hip*
Humans
Knee
Visual Analog Scale
Wounds and Injuries

Figure

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  Fig. 1 Surgeon's view of the surgical field (left hip). The patient lies in lateral decubitus position and head is to the right. Greater trochanter is delineated on the skin as a curve and two portals were used.

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  Fig. 2 Arthroscopic images of left hip of 33-year old female patient. (A) Longitudinal cut is started on the iliotibial band (ITB) distal to the greater trochanter and directed proximally. (B) The final diamondshaped defect of the ITB. (C) Trochanteric bursa is resected through the defect using a shaver and a radiofrequency ablator. (D) Greater trochanter can be observed through the defect after bursectomy. (E) Gluteal sling of the gluteus maximus muscle, inserting to linea aspera. (F) Gluteal sling can be easily and safely released using a flexible radiofrequency ablator.

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