Surgical Technique: Endoscopic Gluteus Maximus Tendon Release for External Snapping Hip Syndrome
Autor: | Emerson Kiyoshi Honda, Giancarlo Polesello, Marcelo Cavalheiro de Queiroz, Nelson Keiske Ono, Benjamin G. Domb |
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Rok vydání: | 2013 |
Předmět: |
Adult
Male Reoperation medicine.medical_specialty Time Factors Adolescent Sports medicine Symposium: Advanced Hip Arthroscopy medicine.medical_treatment Tenotomy Thigh Young Adult Snapping hip syndrome Snapping hip medicine Humans Orthopedics and Sports Medicine medicine.diagnostic_test business.industry Gluteus maximus tendon Endoscopy Recovery of Function General Medicine Anatomy Middle Aged musculoskeletal system medicine.disease Arthralgia Biomechanical Phenomena Surgery body regions Treatment Outcome medicine.anatomical_structure Orthopedic surgery Female Hip Joint Joint Diseases business |
Zdroj: | Clinical Orthopaedics & Related Research. 471:2471-2476 |
ISSN: | 0009-921X |
DOI: | 10.1007/s11999-012-2636-5 |
Popis: | While many authors have recommended surgery for patients with persistent symptoms of external snapping hip, it is unclear which one best relieves symptoms. Concerns with iliotibial band (ITB)-modifying techniques include altering the shape of the lateral thigh and overload of the contralateral abduction mechanism. We describe a new endoscopic technique that decreases the tension of the ITB complex by releasing the femoral insertion of the gluteus maximus tendon (GMT).Via an endoscopic approach, we tenotomize the GMT near its insertion at the linea aspera through two trochanteric portals, developing a space beneath the ITB.We reviewed eight patients (nine hips) with external snapping hip nonresponsive to nonoperative treatment treated by endoscopic GMT release. There were seven women (one bilateral) and one man, with a mean ± SD age of 35 ± 13.1 years (range, 18-55 years). Mean symptom duration was 36 ± 20.3 months (range, 16-84 months). Minimum followup was 22 months (mean, 32 ± 9.3 months; range, 22-45 months).Snapping and pain resolved in seven patients after the initial procedure. We performed one revision procedure with complete relief of symptoms. All eight patients returned to their previous level of activity. Average modified Harris hip score was 61 points (range, 45-70 points) preoperatively and 78 points (range, 62-93 points) at latest followup. We observed no neurovascular complications.Our small series suggests endoscopic release of the GMT resolves pain and snapping symptoms in most patients. |
Databáze: | OpenAIRE |
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