Snapping Hip Syndrome

Snapping Hip Syndrome is described as audible or palpable snap heard during flexion and extension movement of the hip and maybe associated with or without pain. Snapping hip syndrome is classified into two categories intraarticular and Extraarticular. Intraarticular is due to the lesion in the joint itself. It includes synovial chondromatosis, labral tears and fracture fragments or loose bodies. Internal types occur when iliopsoas tendon subluxates over the iliopectineal eminence or the anterior aspect of femoral head and capsule [1, 2, 3, 4, 5, 6]. External type occurs when thick taut posterior border of iliotibial band moves over the greater trocanter [1]. Classification is important to rule out the exact pathology and cause of snapping for

External snapping hip syndrome was first reported by Valderrama in 1969[7]. It can be idiopathic, congenital and genetic or acquired [10, 11, 20, 21]. Commonly seen in athletes like ballet dancers, runners and soccer players [1, 22]. Intramascular injections of antibiotics and anti malarial agents have been associated causes. [23,24,25,26] First step of management of external snapping hip is conservative. This consists of rest, avoiding movement that provoke snapping,

It provides early rehabilitation, small scar, less blood loss, less time consuming and better patient complaints.Arthroscopy of the hip was first reported by Burman in 1931[41]. Hip arthroscopy was of no value to the clinical practice at that time. In late 80’s and early 90’s Glick et.al[42]and Byrd[2] published their results using the lateral and supine approaches. Since then many reports were published on therapeutic procedures.Diagnosis of external snapping hip is basically based on history and examination. However imaging has to be done to confirm the diagnosis and to rule out other pathology. Anteroposterior pelvis x-ray is done to identify bony abnormalities, calcifications, avulsion of greater trocanter, loss of joint space, pincer lesions, acetabular dysplasia and other pathology. Dynamic ultrasonography diagnoses snapping phenomenon. it also detect associated pathology such as tendinitis, bursitis or muscle tears[43,44].Magnetic resonance imaging(MRI) is important investigation to diagnose soft tissues pathology surrounding the hip[45].Iliopsoas bursitis, trochantric bursitis and abductor muscle(gluteus maximus, gluteus medius, gluteus minimus, tensior fascialata)tear can be diagnosed by MRI.
In this study we retrospectively reviewed the result of endoscopy surgery for the release of multiple fibrosis of iliotibial band or gluteus maximus for the treatment of external snapping hip. This novel