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.

[1]  David R. Maldonado,et al.  Teamwork in hip preservation: the ISHA 2019 Annual Scientific Meeting , 2020, Journal of hip preservation surgery.

[2]  Jun Ho Kim,et al.  External snapping hip: classification based on magnetic resonance imaging features and clinical correlation , 2020, Hip international : the journal of clinical and experimental research on hip pathology and therapy.

[3]  W. Vasileff,et al.  CrossFit-related hip and groin injuries: a case series , 2020, Journal of hip preservation surgery.

[4]  W. Hammer Snapping Hip Syndrome. , 2018, Orthopedic nursing.

[5]  K. Issa,et al.  External snapping hip: a systematic review of outcomes following surgical intervention: External snapping hip systematic review , 2018, Hip international : the journal of clinical and experimental research on hip pathology and therapy.

[6]  Juncheng Cui,et al.  Comparison of arthroscopic versus open surgery on external snapping hip caused by gluteal muscle contracture. , 2018, Hip international : the journal of clinical and experimental research on hip pathology and therapy.

[7]  D. Lee,et al.  External Snapping Hip Treated by Effective Designed N-plasty of the Iliotibial Band , 2017, Hip & pelvis.

[8]  B. Cheng,et al.  Clinical outcomes of arthroscopic surgery for external snapping hip , 2017, Journal of Orthopaedic Surgery and Research.

[9]  C. Lewis,et al.  Understanding and Treating the Snapping Hip , 2015, Sports medicine and arthroscopy review.

[10]  K. Yoon,et al.  Arthroscopic Treatment for External Snapping Hip , 2014, Hip & pelvis.

[11]  B. Domb,et al.  Surgical Technique: Endoscopic Gluteus Maximus Tendon Release for External Snapping Hip Syndrome , 2013, Clinical orthopaedics and related research.

[12]  Kenneth S. Lee,et al.  Snapping hip: imaging and treatment. , 2013 .

[13]  N. Simunovic,et al.  Surgical management of internal snapping hip syndrome: a systematic review evaluating open and arthroscopic approaches. , 2013, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[14]  M. Bigoni,et al.  Endoscopic Iliotibial Band Release in Snapping Hip , 2013, Hip international : the journal of clinical and experimental research on hip pathology and therapy.

[15]  Kwang Woo Nam,et al.  A modified Z‐plasty technique for severe tightness of the gluteus maximus , 2011, Scandinavian journal of medicine & science in sports.

[16]  V. Ilizaliturri,et al.  Endoscopic Treatment of Snapping Hips, Iliotibial Band, and Iliopsoas Tendon , 2010, Sports medicine and arthroscopy review.

[17]  C. Lewis Extra-articular Snapping Hip , 2010, Sports health.

[18]  N. Maffulli,et al.  Home Training, Local Corticosteroid Injection, or Radial Shock Wave Therapy for Greater Trochanter Pain Syndrome , 2009, The American journal of sports medicine.

[19]  T. Yoon,et al.  Clinical results of multiple fibrous band release for the external snapping hip , 2009, Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association.

[20]  V. Ilizaliturri,et al.  Endoscopic iliotibial band release for external snapping hip syndrome. , 2006, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[21]  T. Burd,et al.  A New Operative Approach in the Correction of External Coxa Saltans , 2004, The American journal of sports medicine.

[22]  M. Provencher,et al.  The Surgical Treatment of External Coxa Saltans (the Snapping Hip) by Z-Plasty of the Iliotibial Band , 2004, The American journal of sports medicine.

[23]  S. Paik,et al.  Dynamic Sonography of External Snapping Hip Syndrome , 2002, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[24]  A. Faraj,et al.  Snapping iliotibial band. Report of ten cases and review of the literature. , 2001, Acta orthopaedica Belgica.

[25]  W. C. Allen,et al.  Coxa Saltans: The Snapping Hip Revisited , 1995, The Journal of the American Academy of Orthopaedic Surgeons.

[26]  J. S. Keene,et al.  A new operative approach to snapping hip and refractory trochanteric bursitis in athletes , 1986, The American journal of sports medicine.

[27]  W. C. Allen,et al.  The snapping hip syndrome , 1984, The American journal of sports medicine.

[28]  O. Foss,et al.  Endoscopic Treatment of Greater Trochanteric Pain Syndrome - A Case Series of 11 Patients , 2019, Journal of orthopaedic case reports.

[29]  Juncheng Cui,et al.  Comparison of arthroscopic versus open surgery on external snapping hip caused by gluteal muscle contracture , 2018, Hip international : the journal of clinical and experimental research on hip pathology and therapy.

[30]  R. Hobden,et al.  Extraarticular snapping hip: sonographic findings. , 2001, AJR. American journal of roentgenology.

[31]  A. Féry,et al.  [The snapping hip. Late results of 24 surgical cases]. , 1988, International orthopaedics.

[32]  E. Larsen,et al.  Snapping hip. , 1986, Acta orthopaedica Scandinavica.

[33]  V. G. Sison Snapping hip. , 1959, Missouri medicine.

[34]  A. M. Dickinson Bilateral snapping hip , 1929 .