scholarly journals The Optimal Arthroscopic Release Plane of External Snapping Hip

2020 ◽  
Author(s):  
Min Zhu ◽  
Chao Xue ◽  
Mengxiong Song ◽  
Qiuchen Cai ◽  
Biao Cheng ◽  
...  
Keyword(s):  
Great Trochanter ◽  
Arthroscopic Surgery ◽  
Operation Time ◽  
The Other ◽  
Surgical Success ◽  
Arthroscopic Release ◽  
Snapping Hip ◽  
External Snapping Hip ◽  
Plane Group

Abstract Background: Some studies have reported arthroscopic release of external snapping hip(ESH). However, there is no research on the effect of different arthroscopic release plane for ESH. We will study the effect of release plane on arthroscopic surgery, and suggest an optimal release plane.Methods: From September 2017 to December 2018, 177 bilateral and 6 unilateral ESH patients who would receive arthroscopic release of ESH and agree to attend at this study were enrolled. One release plane was randomly offered for each operation hip out of 6 different arthroscopic release planes(referred to the apex of the great trochanter(GT), including planes of -2cm, 0cm, 2cm, 4cm, 6cm and 8cm groups). All patients received continuous follow-up, comparing preoperative and postoperative hip snapping, hip adduction and flexion angles and Harris Hip Scores(HHS). Results: There was no difference in age, gender, body mass index (BMI) and average operation time among different release plane groups (p>0.05). In terms of surgical success rate, the release plane group 4cm (98.33%)> 6cm (96.67%)> 2cm (95.00%)> 0cm (91.67%)> 8cm (8.33%)>-2cm (5.00%) (p<0.05). Although the hip adduction and flexion angles were improved in each group after operation (p<0.05), the improvement in the release plane -2cm and 8cm groups was significantly lower than that in the other four release plane groups (p<0.05). In addition, at 12 months of follow-up, all patients had significantly improved adduction and flexion angles and HHS (p<0.05). Conclusions: The arthroscopic release plane for ESH can affects the surgical effect, and the optimal arthroscopic release plane is 0-6 cm .

Comparison of arthroscopic versus open surgery on external snapping hip caused by gluteal muscle contracture

2018 ◽  
Vol 28 (2) ◽  
pp. 173-177 ◽  
Author(s):  
Zhu Dai ◽  
Zhiwei Chen ◽  
Ying Liao ◽  
Zhengwu Tang ◽  
Juncheng Cui
Keyword(s):  
Postoperative Pain ◽  
Open Surgery ◽  
Arthroscopic Surgery ◽  
Operation Time ◽  
Gluteal Muscle ◽  
Muscle Contracture ◽  
Snapping Hip ◽  
Surgery Group ◽  
Gluteal Muscle Contracture ◽  
External Snapping Hip

Purpose: To compare the outcomes of contracture release by arthroscopic versus open surgical approach in patients with external snapping hip (ESH) caused by gluteal muscle contracture (GMC). Methods: Medical records of patients with ESH due to GMC who underwent open surgery (n = 44) or arthroscopic surgery (n = 48) between October 2008 and October 2014 were reviewed. Patients were followed up at 1, 3, 12, and 24 months postoperatively. Operation time, incision length, postoperative pain, postoperative complication rate, and recurrence rate were compared between the 2 groups. Hip adduction, and Harris Hip Scores (HHS) at 1 and 2 years postoperatively were compared between the groups and with preoperative data. Results: Mean operation time did not differ between the 2 groups (p>0.05). The arthroscopic surgery group had smaller incisions (p<0.05), less postoperative pain (p<0.05), lower complication rates (p<0.05) than did the open surgery group. The recurrence rates were similar for the 2 groups (p>0.05). Hip adduction, and HHS 1 year and 2 years postoperatively were significantly better postoperatively than they had been preoperatively for both groups (all p<0.01), and were similar for the 2 groups (all p>0.05). Conclusions: Arthroscopic release of contracture tissue is a safe and effective approach for the treatment of ESH caused by GMC, with the advantages of small scars, less postoperative pain, fewer complications compared with open surgery.

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

2021 ◽  
Author(s):  
Chun-Ting Chu ◽  
Huan Hsu ◽  
Hao-Che Tang ◽  
Alvin Chao-Yu Chen ◽  
Yi-Sheng Chan
Keyword(s):  
Clinical Outcomes ◽  
Arthroscopic Surgery ◽  
Harris Hip Score ◽  
Iliotibial Band ◽  
Snapping Hip ◽  
External Snapping Hip ◽  
Modified Harris Hip Score ◽  
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.

scholarly journals The Optimal Arthroscopic Release Plane of External Snapping Hip

2020 ◽  
Keyword(s):  
Arthroscopic Release ◽  
Snapping Hip ◽  
External Snapping Hip

Abstract The authors have requested that this preprint be withdrawn due to erroneous posting.

scholarly journals Fluoroscopy guided stent placement for the treatment of malignant afferent loop obstruction

2021 ◽  
Author(s):  
Chaoyang Wang ◽  
Xiaoyi Duan ◽  
Lequn Wei ◽  
Tong Wang ◽  
Huanzhang Niu
Keyword(s):  
Tumor Progression ◽  
Stent Placement ◽  
Clinical Symptoms ◽  
Operation Time ◽  
The Other ◽  
Efficacy And Safety ◽  
Safe Method ◽  
Afferent Loop ◽  
Afferent Loop Obstruction

Abstract BACKGROUND & AIM: To evaluate the efficacy and safety of fluoroscopy guided stent placement for the treatment of malignant afferent loop obstruction (ALO). METHODS 12 patients with malignant ALO in whom fluoroscopy guided stent placement had been performed were analyzed retrospectively. The operation time, clinical efficacy, complications and postoperative hospitalization were observed. Follow-up was scheduled at 1 and 3 months after the operation, and every 3 months thereafter, or when the patients developed clinical symptoms related to ALO. RESULTS Stent placement was performed successfully in 11 patients with an average time of 37.9 ± 12.2 min. For the other one patient, we adopted transnasal drainage tube implantation in afferent loop instead of stent placement. All the patients had an obvious relief of clinical symptoms, and no serious complications occurred. During the follow-up, 1 patient had restenosis 12 months later as the tumor grew across the stent mesh. 7 patients died of tumor progression at 3, 4.5, 5, 7, 8, 11 and 15 months after the operation. CONCLUSION Fluoroscopy guided stent placement is an effective and safe method for the treatment of malignant ALO.

scholarly journals The Learning Curve in Vaginal Pelvic Reconstruction Surgery for Severe Pelvic Organ Prolapse: Analysis of the Cumulative Summation Test (CUSUM)

2021 ◽  
Author(s):  
Chin-Jui Wu ◽  
Kuan-Ju Huang ◽  
Wen-Chun Chang ◽  
Ying-Xuan Li ◽  
Lin-Hung Wei ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Learning Curve ◽  
Reconstructive Surgery ◽  
Operation Time ◽  
Pelvic Organ ◽  
Pelvic Reconstructive Surgery ◽  
Surgical Success ◽  
Advanced Pelvic Organ Prolapse ◽  
Cumulative Summation

Abstract Women who underwent vaginal pelvic reconstructive surgery with or without mesh consecutively between 2004 and 2018 were retrospectively analyzed to determine the learning curve in vaginal pelvic reconstructive surgery. With cumulative summation (CUSUM) analysis of surgical failure and operation time, we assessed the learning curve of vaginal pelvic reconstructive surgery, including sacrospinous ligament fixation, anterior colporrhaphy, posterior colporrhaphy, and optional vaginal hysterectomy with or without mesh placement. Two hundred and sixty-four women with stage III or IV pelvic organ prolapse underwent vaginal pelvic reconstructive surgery by surgeon A or B. The median follow-up time of 44 months ranged from 24 to 120 months. Surgical proficiency was achieved in 32-54 vaginal pelvic reconstructive surgery procedures without mesh and 37-61 procedures in the same surgery with mesh. The surgical success rates for surgeons A and B were 82.2% and 94.1%, with median follow-up times of 60 and 33 months, respectively. The learning phase of vaginal pelvic reconstructive surgery in advanced pelvic organ prolapse in this institutional cohort required 54 and 61 procedures, respectively. A higher number of procedures were required for the learning curve of vaginal pelvic reconstructive surgery with mesh. Having crossed the boundary of proficiency, the surgical success rate and operation time were improved.

scholarly journals Endoscopic gluteus maximus tendon release for external snapping hip syndrome: a functional assessment

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Filippo Randelli ◽  
Alberto Fioruzzi ◽  
Mauro Magnani ◽  
Manuel Mazzoleni ◽  
Mohammad Elhiny ◽  
...  
Keyword(s):  
Gluteus Maximus ◽  
Comparative Trial ◽  
Contralateral Side ◽  
Harris Hip Score ◽  
Level Of Evidence ◽  
Thigh Circumference ◽  
Snapping Hip ◽  
External Snapping Hip ◽  
Snapping Hip Syndrome

Abstract Purpose The aim of this retrospective study was to investigate the clinical follow-up of patients with external snapping hip syndrome (ESHS) treated with endoscopic gluteus maximus tendon release and to compare the residual muscular strength and thigh circumference as an indirect outcome measure. Methods Patients of all ages with external snapping hip syndrome were treated with endoscopic gluteus maximus tendon release. Outcome measures evaluated included: visual analog scale (VAS), modified Harris Hip Score (mHHS), and Non-Arthritic Hip Score (NAHS). The gluteus maximus strength and the circumference of the thigh were also evaluated. Results Among 25 patients, 23 fulfilled the inclusion criteria and one patient was lost to follow-up. The series included 22 patients, 6 males and 16 females with a mean age of 27.9 ± 13.4 years (range 16–76 years). All patients had resolution of the snapping symptoms after the procedure. The mean follow-up was 18 ± 9.3 months. All outcomes improved in a statistically significant manner: VAS value decreased from 6.8 (range 6–8) to 0.6 (range 0–4) (p  < 0.001), mHHS increased from 48.6 (range 17.6–67) to 88.2 (range 67–94.6) (p  <  0.001), NAHS increased from 49.0 (range 21.5–66) to 90.8 (range 66–98.75) (p  <  0.001). A statistically significant reduction of operated limb thigh circumference compared to the contralateral side (3.7%) was also found, while there were no statistical differences regarding the strength of gluteus maximus muscles. Conclusions Endoscopic gluteus maximus tendon release is an excellent surgical option to treat snapping hip syndrome. The evaluated muscle strength revealed no functional impairment. The significance of the limb circumference reduction has yet to be determined. Level of evidence IV: retrospective comparative trial.

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