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Outcomes after arthroscopic treatment of external snapping hip
Arthrosc Orthop Sports Med 2022;9:67-72
Published online November 1, 2022;  https://doi.org/10.14517/aosm22009
© 2022 Korean Arthroscopy Society and Korean Orthopedic Society for Sports Medicine.

Jung-Wee Park1, Yong-Chan Ha2

1Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, 2Department of Orthopaedic Surgery, Seoul Bumin Hospital, Seoul, Korea
Correspondence to: Yong-Chan Ha, https://orcid.org/0000-0002-6249-0581
Department of Orthopaedic Surgery, Seoul Bumin Hospital, 389 Gonghang-daero, Gangseo-gu, Seoul 07590, Korea. Tel: +82-2-2620-5101, Fax: +82-2-2620-0100, E-mail: hayongch@naver.com
Received April 8, 2022; Revised September 13, 2022; Accepted September 24, 2022.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Arthroscopic iliotibial band (ITB) release has been used as one of the surgical options for patients with external snapping hip who have failed in conservative treatments. This study aimed to evaluate the clinical outcomes of arthroscopic ITB release for painful external snapping hips.
Methods: Between April 2011 and October 2019, 13 patients (10 males and 3 females: mean age, 23 y; range, 19–36 y) with painful external snapping hip were treated with arthroscopic ITB release following the failure of conservative treatment for at least 3 months. The patients were followed up for a minimum of 27 months postoperatively. Clinical improvements were assessed using the pain visual analog scale (VAS), University of California, Los Angeles (UCLA) activity, and Harris hip score (HHS).
Results: Trochanteric pain improved in all patients. Painless snapping recurred in one patient. None of the patients had painful snapping or required revision surgery after the arthroscopic ITB release. The mean pain VAS score decreased from 7.4 (range, 6–9) preoperatively to 3.2 (range, 1–6) postoperatively (P < 0.001). The mean UCLA activity increased from 5.7 (range, 4–10) preoperatively to 8.1 (range, 4–10) postoperatively (P = 0.005). The mean HHS improved from 61.1 (range, 48–96) preoperatively to 78.9 (range, 65–100) points postoperatively (P = 0.014).
Conclusion: Arthroscopic ITB release is considered a safe and effective technique for patients with refractory external snapping hip.
Keywords : External snapping hip syndrome; Arthroscopy; Iliotibial band release; Treatment outcome
References
  1. Maffulli N, Binfield PM, King JB. Tendon problems in athletic individuals. J Bone Joint Surg Am 1998;80:142-4.
    Pubmed CrossRef
  2. White RA, Hughes MS, Burd T, Hamann J, Allen WC. A new operative approach in the correction of external coxa saltans: the snapping hip. Am J Sports Med 2004;32:1504-8.
    Pubmed CrossRef
  3. Brignall CG, Brown RM, Stainsby GD. Fibrosis of the gluteus maximus as a cause of snapping hip. A case report. J Bone Joint Surg Am 1993;75:909-10.
    Pubmed CrossRef
  4. Nam KW, Yoo JJ, Koo KH, Yoon KS, Kim HJ. A modified Z-plasty technique for severe tightness of the gluteus maximus. Scand J Med Sci Sports 2011;21:85-9.
    Pubmed CrossRef
  5. Larsen E, Johansen J. Snapping hip. Acta Orthop Scand 1986;57:168-70.
    Pubmed CrossRef
  6. Zoltan DJ, Clancy WG Jr, Keene JS. A new operative approach to snapping hip and refractory trochanteric bursitis in athletes. Am J Sports Med 1986;14:201-4.
    Pubmed CrossRef
  7. Yoon TR, Park KS, Diwanji SR, Seo CY, Seon JK. Clinical results of multiple fibrous band release for the external snapping hip. J Orthop Sci 2009;14:405-9.
    Pubmed CrossRef
  8. Brignall CG, Stainsby GD. The snapping hip. Treatment by Zplasty. J Bone Joint Surg Br 1991;73:253-4.
    Pubmed CrossRef
  9. Provencher MT, Hofmeister EP, Muldoon MP. The surgical treatment of external coxa saltans (the snapping hip) by Z-plasty of the iliotibial band. Am J Sports Med 2004;32:470-6.
    Pubmed CrossRef
  10. Park JS, Kim WJ, Lee DW, et al. External snapping hip treated by effective designed N-plasty of the iliotibial band. Hip Pelvis 2017;29:187-93.
    Pubmed KoreaMed CrossRef
  11. Schaberg JE, Harper MC, Allen WC. The snapping hip syndrome. Am J Sports Med 1984;12:361-5.
    Pubmed CrossRef
  12. Ilizaliturri VM Jr, Martinez-Escalante FA, Chaidez PA, Camacho-Galindo J. Endoscopic iliotibial band release for external snapping hip syndrome. Arthroscopy 2006;22:505-10.
    Pubmed CrossRef
  13. Randelli F, Mazzoleni MG, Fioruzzi A, Giai Via A, Calvisi V, Ayeni OR. Surgical interventions for external snapping hip syndrome. Knee Surg Sports Traumatol Arthrosc 2021;29:2386-93.
    Pubmed KoreaMed CrossRef
  14. Zhang S, Dong C, Li Z, et al. Endoscopic iliotibial band release during hip arthroscopy for femoroacetabular impingement syndrome and external snapping hip had better patient-reported outcomes: a retrospective comparative study. Arthroscopy 2021;37:1845-52.
    Pubmed CrossRef
  15. Chu CT, Hsu H, Tang HC, Chen AC, Chan YS. Mid- to long-term clinical outcomes of arthroscopic surgery for external snapping hip syndrome. J Hip Preserv Surg 2021;8:172-6.
    Pubmed KoreaMed CrossRef
  16. Winston P, Awan R, Cassidy JD, Bleakney RK. Clinical examination and ultrasound of self-reported snapping hip syndrome in elite ballet dancers. Am J Sports Med 2007;35:118-26.
    Pubmed CrossRef
  17. Amstutz HC, Thomas BJ, Jinnah R, Kim W, Grogan T, Yale C. Treatment of primary osteoarthritis of the hip. A comparison of total joint and surface replacement arthroplasty. J Bone Joint Surg Am 1984;66:228-41.
    Pubmed CrossRef
  18. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 1969;51:737-55.
    CrossRef
  19. Polesello GC, Queiroz MC, Domb BG, Ono NK, Honda EK. Surgical technique: endoscopic gluteus maximus tendon release for external snapping hip syndrome. Clin Orthop Relat Res 2013;471:2471-6.
    Pubmed KoreaMed CrossRef
  20. Zini R, Munegato D, De Benedetto M, Carraro A, Bigoni M. Endoscopic iliotibial band release in snapping hip. Hip Int 2013;23:225-32.
    Pubmed CrossRef
  21. Yoon JY, Kwak HS, Yoon KS, Chang JS, Yoon PW. Arthroscopic treatment for external snapping hip. Hip Pelvis 2014;26:173-7.
    Pubmed KoreaMed CrossRef
  22. Shrestha A, Wu P, Ge H, Cheng B. Clinical outcomes of arthroscopic surgery for external snapping hip. J Orthop Surg Res 2017;12:81.
    Pubmed KoreaMed CrossRef
  23. Dai Z, Chen Z, Liao Y, Tang Z, Cui J. Comparison of arthroscopic versus open surgery on external snapping hip caused by gluteal muscle contracture. Hip Int 2018;28:173-7.
    Pubmed CrossRef
  24. Maldonado DR, Glein RM, Lee MS, et al. Patients with concomitant painful external snapping hip and femoroacetabular impingement syndromes reported complete snapping resolution with release of the gluteus maximus and iliotibial band, and comparable minimum 2-year outcomes to a propensity-matched control group. Arthroscopy 2022;38:1890-9.
    Pubmed CrossRef
  25. Kunac N, Trsek D, Medancić N, Starcević D, Haspl M. Endoscopic treatment of the external snapping hip syndrome: surgical technique and report of two cases. Acta Clin Croat 2012;51:661-6.


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