Clinical results of multiple fibrous band release for the external snapping hip

Yoon, Taek Rim; Park, Kyung Soon; Diwanji, Sanket R.; Seo, Chang Young; Seon, Jong Keun

doi:10.1007/s00776-009-1350-y

Cited by 28 publications

(48 citation statements)

References 11 publications

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“…Using our transversal type of release of the ITB, we obtained a resolution of the snapping in all the patients. Residual snapping due to an incomplete release has been reported by different authors (4,6,8,17,26,(28)(29)(30)(31). …”

Section: Discussionmentioning

confidence: 91%

Endoscopic Iliotibial Band Release in Snapping Hip

et al. 2013

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Several open surgical techniques have been used to treat recalcitrant cases of snapping iliotibial band with varying results. Recently, endoscopic techniques have become available. The purpose of this study was to investigate the results of a modified endoscopic iliotibial band release using a longitudinal retrospective case series.  Fifteen patients (three men and 12 women) with symptomatic external snapping hip were treated with an endoscopic release of the iliotibial band. The average age was 25 years (range 16-37 years). The procedure was performed in the lateral decubitus position using two portals; the iliotibial band was transversally released using a radiofrequency hook probe. The mean follow-up period was 33.8 months (range 12-84 months).  The snapping phenomenon was overcome in all the patients. The mean pre-op pain VAS score was 5.5 mm (range 5-7 mm) and the mean post-op pain VAS score was 0.53 mm (range 0-2 mm) with a statistically significant reduction with respect to the preoperative value (p<0.0001); sixty percent of the patients were pain-free. The mean postoperative Harris Hip Score was 97.5 (range 94-100). No revision procedures were indicated and all the patients returned to their previous level of activity. The mean patient satisfaction score was, on average, 9.3 mm (range 8-10 mm) on the VAS scale. No complications occurred.  Endoscopic iliotibial band release is a safe and reproducible technique with excellent results in terms of snapping phenomenon resolution, patient satisfaction, and return to previous level of activity. After strenuous sporting activities 40% of patients complained of very slight pain.

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Section: Discussionmentioning

confidence: 91%

Endoscopic Iliotibial Band Release in Snapping Hip

et al. 2013

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“…In external snapping hip the iliotibial band snap over the trochantor major, which may cause an eccentric overload of the gluteals and the iliotibial band during movement as it was reported by Simonsen et al [12]. However, other studies suggest that tightness of the iliotibial band is one of the main contributing factor to iliotibial snapping [3,5]. Further investigations are needed to explore a possible relationship between snapping hip and joint hypermobility.…”

Section: Discussionmentioning

confidence: 98%

“…External snapping hip is present when the iliotibial tract and/or the posterior border of gluteus maximus slide over the greater trochanter [1-3]. Symptomatic external snapping hip is a painful condition, where pain in the trochantor region and limitations of daily activity dominate clinical findings [1,4,5].…”

Section: Introductionmentioning

confidence: 99%

“…The aetiology of external snapping hip is elusive, but previous studies have suggested that weakness of the hip abductors, leg length, tightness of the iliotibial band, foot mechanics, altered walking and hip instability may play a role in the development of the condition [3,6-9]. During walking the hip abductors work eccentrically after initial foot contact to resist an external adduction moment [10,11].…”

Section: Introductionmentioning

confidence: 99%

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The gait pattern is not impaired in subjects with external snapping hip: a comparative cross-sectional study

Jacobsen

Kersting

Rathleff

et al. 2013

BMC Musculoskelet Disord

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BackgroundSymptomatic external snapping hip is a painful condition, where pain in the trochantor region and limitations of daily activity dominate clinical findings. The aetiology of symptomatic external snapping hip is elusive, but previous studies have suggested that weakness of the hip abductors and an altered walking pattern may play a role in the development of symptomatic external snapping hip. The aim of this study was to compare the walking pattern and muscular activity of the hip muscles between subjects with symptomatic external snapping hip and healthy subjects.MethodsThirteen subjects with diagnosed symptomatic external snapping hip (age: 25.5 years) were matched with 13 healthy subjects (age: 25.6 years). Joint kinematics and kinetics of the lower extremity were quantified by the peak hip adduction angle; the average knee rotation range of motion (ROM) and the peak valgus knee angle after data recording using a Vicon 612 motion capture system. Muscle activity was recorded bilaterally using surface electromyography (sEMG) on five muscles: gluteus maximus, gluteus medius, tensor fascia latae, rectus femoris and biceps femoris. A paired t-test was used to evaluate differences between the two groups.ResultsNo significant differences were found between the groups concerning the peak hip adduction angle, the average knee rotation ROM, and the static valgus knee angle. No significant between-group differences were found concerning all other kinematics, kinetics or muscle activity. In subjects with symptomatic external snapping hip activity of the gluteus medius muscle during the acceptance phase of walking was 0.58 ± 0.19 whereas the activity was 0.68±0.07 in the asymptomatic group (p=0.115).ConclusionsNo significant differences in the walking pattern were found between subjects with symptomatic external snapping hip and healthy subjects. This suggest that subjects with symptomatic external snapping hip does not have an impaired gait pattern.

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“…In addition, excellent visualization of the entire peritrochanteric space is possible, and accessory tendinous structures from the gluteus minimus that may also be a culprit in snapping or painful trochanteric bursitis identified and cut. 34,40,41 Drawbacks to this approach include the need for familiarity with the endoscopic anatomy of the peritrochanteric compartment, including comfort with the relative location of the sciatic nerve that lies posteriorly and may be variably close based on rotation of the limb.…”

Section: Peritrochanteric or Lateral Compartmentmentioning

confidence: 99%

Arthroscopy of the Hip, The Snapping Hip

Shu

Safran

2012

Techniques in Orthopaedics

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The arthroscopic management of the snapping hip can be accomplished with minimal morbidity and successful, reproducible results. Typical internal and external snapping hip are treated by relative lengthening of the tendinous portion of the iliopsoas or the iliotibial band, respectively. The evidence-based literature is sparse, and this reflects the rarity of patient cases that necessitate operative intervention. However, clinical experience offers guidance. Select patients who have symptomatic snapping that has failed an adequate trial of good nonoperative management, that includes stretching and strengthening of the affected tendon. Tailor the surgical approach to the patient. For internal snapping, options include (1) at the level of the lesser trochanter (may be ideal for hip arthroplasty patients); (2) peripheral compartment; and (3) central compartment. Generally, the senior author prefers inspection of the central compartment to address any concomitant intra-articular pathology, followed by peripheral compartment iliopsoas tendon lengthening. The results of this approach are superior to open approaches in addressing internal snapping hip. External snapping approaches include (1) subcutaneous excision of the center of the iliotibial band; and (2) peritrochanteric approach where just the posterior third of the iliotibial band can be addressed directly and selectively; both have equivalent results and appear equivalent with open approaches. Recognize other factors that may influence surgical success such as accurate lengthening; and for internal snapping, associated impingement, labral and/or chondral pathology, heterotopic ossification, femoral anteversion, capsuloligamentous laxity, prior hip arthroplasty; for external snapping, trochanteric bursitis, gluteal tendinopathy and tears, as well as voluntary snappers.

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Clinical results of multiple fibrous band release for the external snapping hip

Cited by 28 publications

References 11 publications

Endoscopic Iliotibial Band Release in Snapping Hip

Endoscopic Iliotibial Band Release in Snapping Hip

The gait pattern is not impaired in subjects with external snapping hip: a comparative cross-sectional study

Arthroscopy of the Hip, The Snapping Hip

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