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Endoscopic Release of the Iliotibial Band for Snapping Hip Syndrome

There's a band of tissue along the outside of the thigh called the iliotibial band or ITB. In a small number of people (usually women) a thickening of the posterior edge of the ITB can cause a condition called the external snapping hip syndrome. When the patient bends or flexes the leg up, the ITB slides over the hipbone and "snaps." Pain occurs with the snapping if the bursa (protective pad) between the ITB and the bone gets inflamed.

In this study, surgeons use an endoscope in a closed operation to cut the ITB. Results were compared to the open cut method of operation. Ten patients were included. Nine were women; one woman had both hips done.

The authors carefully describe the surgical method. Patient position, use of supports, and draping are described. Saline (liquid) is injected between the bone and the ITB to develop a space under the ITB.

After a small opening is made, an arthroscope is inserted. A special needle (endoscope) is used through the arthroscope to cut a diamond-shaped portion of the ITB and release the tension. The bursa is taken out. The patient is tested for any snapping left over. When the snapping is all gone, the saline is removed and the incision is closed.

Results were 100% for pain relief. One patient still had snapping but no pain. The authors conclude that endoscopic release of the ITB for snapping hip syndrome works well. It offers a minimally invasive way to surgically treat this problem when nothing else works. Studies with more patients and longer follow-up are still needed to confirm the use of this operation.

References: Victor M. Ilizaliturri, Jr., MD, et al. Endoscopic Iliotibial Band Release for External Snapping Hip Syndrome. In The Journal of Arthroscopic and Related Surgery. May 2006. Vol. 22. No. 5. Pp. 505-510.

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