Internal Snapping Hip Syndrome: Treatment by Endoscopic Release of the Iliopsoas Tendon

Introduction: Internal snapping hip syndrome (ISHS) is caused by the iliopsoas tendon snapping over either the iliopectineal ridge or the anterior femoral head. Excellent results are achieved only with activity modification, rest, and stretching the iliopsoas muscle. The literature favors iliopsoas tendon release if conservative therapy fails. There is little evidence about the gold standard of this condition. Objective: Describe clinical results, complicactions and recurrence rate of arthroscopic treatment of ISHS. Methods: We included all patients who failed conservative treatment and were treated with arthroscopy for ISHS between March 2012 and March 2018. Patients with less than 2 years of follow up and previous surgery on the hip were excluded. We performed Ilizariturri´s technique with a transcapsular endoscopic release in central compartment. We registered modified Harris hip score (MHHS), Hip outcome score activity of daily living (EHOSDL), patients satisfaction, recurrence rate and complications. Results: Eight patients were included. Average follow up was 36 months (range 24-60 months). MMHS improved from preoperative average score of 70 (range 62-72) to postoperative average of 93 (range 92 to 96). Average EHOSDL improvement was 30% (from 55% preoperative to 85% postoperative). All patients had excellent results. Average patient satisfaction was 8 (range 7-9). We had no recurrence or complications. Conclusion: Arthroscopic treatment of ISHS allowed us to obtain very good clinical results with no complications or recurrences with a minimum 2 years follow up.

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Endoscopic Release of the External Snapping Hip Syndrome (SS-69)

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/j.arthro.2005.04.075 ◽

2005 ◽

Vol 21 (6) ◽

pp. e34

Keyword(s):

Snapping Hip ◽

Endoscopic Release ◽

External Snapping Hip ◽

Snapping Hip Syndrome

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Iliopsoas bursa imaging: efficacy in depicting abnormal iliopsoas tendon motion in patients with internal snapping hip syndrome.

Radiology ◽

10.1148/radiology.197.3.7480768 ◽

1995 ◽

Vol 197 (3) ◽

pp. 853-856 ◽

Cited By ~ 54

Author(s):

J P Vaccaro ◽

D D Sauser ◽

R K Beals

Keyword(s):

Iliopsoas Tendon ◽

Snapping Hip ◽

Iliopsoas Bursa ◽

Snapping Hip Syndrome

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Prospective Randomized Study of 2 Different Techniques for Endoscopic Iliopsoas Tendon Release in the Treatment of Internal Snapping Hip Syndrome

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/j.arthro.2008.08.009 ◽

2009 ◽

Vol 25 (2) ◽

pp. 159-163 ◽

Cited By ~ 95

Author(s):

Victor M. Ilizaliturri ◽

Carlos Chaidez ◽

Patricio Villegas ◽

Arcadio Briseño ◽

Javier Camacho-Galindo

Keyword(s):

Randomized Study ◽

Prospective Randomized Study ◽

Iliopsoas Tendon ◽

Snapping Hip ◽

Snapping Hip Syndrome

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Iliopsoas Tendon Reformation after Psoas Tendon Release

Case Reports in Orthopedics ◽

10.1155/2013/361087 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

K. Garala ◽

R. A. Power

Keyword(s):

Surgical Intervention ◽

Symptom Relief ◽

Prevalence Rates ◽

Iliopsoas Tendon ◽

Lesser Trochanter ◽

Snapping Hip ◽

Surgical Options ◽

Snapping Hip Syndrome ◽

Long Term Studies

Internal snapping hip syndrome, or psoas tendonitis, is a recognised cause of nonarthritic hip pain. The majority of patients are treated conservatively; however, occasionally patients require surgical intervention. The two surgical options for iliopsoas tendinopathy are step lengthening of the iliopsoas tendon or releasing the tendon at the lesser trochanter. Although unusual, refractory snapping usually occurs soon after tenotomy. We report a case of a 47-year-old active female with internal snapping and pain following an open psoas tenotomy. Postoperatively she was symptom free for 13 years. An MRI arthrogram revealed reformation of a pseudo iliopsoas tendon reinserting into the lesser trochanter. The pain and snapping resolved after repeat iliopsoas tendon release. Reformation of tendons is an uncommon sequela of tenotomies. However the lack of long-term studies makes it difficult to calculate prevalence rates. Tendon reformation should be included in the differential diagnosis of failed tenotomy procedures after a period of symptom relief.

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Surgical interventions for external snapping hip syndrome

Knee Surgery Sports Traumatology Arthroscopy ◽

10.1007/s00167-020-06305-w ◽

2020 ◽

Author(s):

Filippo Randelli ◽

Manuel Giovanni Mazzoleni ◽

Alberto Fioruzzi ◽

Alessio Giai Via ◽

Vittorio Calvisi ◽

...

Keyword(s):

Lateral Side ◽

Level Of Evidence ◽

Endoscopic Surgical Procedures ◽

Surgical Interventions ◽

Endoscopic Techniques ◽

Snapping Hip ◽

Endoscopic Release ◽

Hip Range Of Motion ◽

External Snapping Hip ◽

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.

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Síndrome da Anca de Ressalto

Revista de Medicina Desportiva ◽

10.23911/rmd.vol9.iss1.pp8-11 ◽

2018 ◽

Vol 9 (1) ◽

pp. 8

Author(s):

Bernardo Almeida

Keyword(s):

Surgical Treatment ◽

Hip Joint ◽

Scientific Literature ◽

Therapeutic Targets ◽

Clinical History ◽

Disease Diagnosis ◽

Diagnosis And Treatment ◽

Snapping Hip ◽

Predominant Symptom ◽

Snapping Hip Syndrome

Snapping hip syndrome is a condition in which the predominant symptom is the snapping feelingaround the hip joint caused by a dynamic impingement between muscles or tendons and boneprominences. The etiology of the snapping hip types and consequently the therapeutic targets havebeen subjects of discussion and controversy along the years. A careful clinical history and physicalexamination is frequently enough for this disease diagnosis. Treatment is typically conservative,however when it is not successful surgical treatment is indicated, consisting on the snapping muscleor tendons lengthening. The authors review in this paper the current scientific literature about functionalanatomy, physiopathology, symptoms, diagnosis and treatment of snapping hip.

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