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PurposeIschiofemoral impingement is considered to be an uncommon and difficult pathology to diagnose with respect to hip pain etiology. The objective was to describe the clinical results of endoscopic lesser trochanter resection via a posterior approach in patients with Ischiofemoral impingement. MethodsThis was a retrospective observational study of consecutive patients with Ischiofemoral impingement, who underwent endoscopic resection of the lesser trochanter via a posterior approach, between 2015 and 2018. Clinical results were evaluated using the ischiofemoral impingement test, long‐stride walking test, modified Harris Hip Score (mHHS) and the Oxford scale to assess the strength of the iliopsoas muscle as well as the presence of complications. Preoperative and postoperative ischiofemoral space was measured to assess whether the resection of the lesser trochanter was adequate. Results16 hips in 13 patients (mean age: 34.4 ± 12.1 years, 11 women) with a follow‐up period between 24 and 59 months were included. Preoperative ischiofemoral space ranged from 6.4 to 22.4 mm, a measure > 17.0 mm was achieved in 15 hips without the presence of pain in IFI test and long‐strides walking test. Function improved postoperatively, as reflected by a higher mean mHHS (preoperative: 44.6 ± 21.5, postoperative: 81.2 ± 15.1, p < 0.05). After surgery, the strength of the iliopsoas muscle was not decreased compared to the preoperative measure. Three complications were reported, including two cases that required revision surgery. ConclusionsEndoscopic resection of the lesser trochanter via posterior approach provides satisfactory outcomes with symptom relief and good functional results in patients with Ischiofemoral impingement. It is important to discuss the benefits and risks when offering this treatment choice. Level of EvidenceLevel IV

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To describe the functional results of arthroscopic treatment in patients with femoroacetabular impingement (FAI) and subspine impingement (SSI) evaluated with a 3-dimensional (3D) dynamic study. Methods: This was a retrospective observational study of patients with a diagnosis of FAI and SSI, evaluated with a 3D dynamic computed tomography scan with Move Forward software, who underwent hip arthroscopy between February 2015 and December 2017. Measurements of the alpha angle, femoral anteversion, acetabular anteversion, lateral center-edge angle, and Tönnis angle were extracted from the 3D dynamic study. Functionality was evaluated using the Western Ontario McMaster Universities Osteoarthritis Index before and 12 months after surgery. Results: We analyzed 22 hips in 17 patients (9 female and 8 male patients) with an average age of 34.6 AE 14.3 years. Of the 22 hips, 15 had cam morphology, 6 had mixed morphology, and 1 had pincer morphology. Of the hips, 11 had a type I spine, 10 had type II, and 1 had type III. The average alpha angle, Tönnis angle, femoral anteversion, and acetabular anteversion were 61.9 AE 11.1 , 2.5 AE 6.4 , 8.8 AE 6.8 , and 15.1 AE 7.1 , respectively. The median lateral center-edge angle was 38.1 (interquartile range, 32.6-43.5). At 1-year follow-up, a decrease in the Western Ontario McMaster Universities Osteoarthritis Index score (P ¼ .001) and an increase in the flexion angle (P < .001) were observed. No cases needed posterior surgical revision because of persistent pain. Conclusions: Arthroscopic treatment provides symptom relief and good functional results in patients with FAI and SSI. Level of Evidence: Level IV, therapeutic case series.

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