Orthopaedics, The Ohio State University, Columbus, United States.
Int J Sports Med. 2013 Oct;34(10):851-5. doi: 10.1055/s-0032-1321797. Epub 2013 Jun 5.
Our purpose was to evaluate evidence regarding the effectiveness of open iliopsoas release and lengthening with arthroscopic approaches, which combine iliopsoas release with the treatment of intra-articular pathology as treatments for internal snapping hip syndrome. Searches were performed of 4 databases and 12 reports on the surgical treatment of internal snapping hip were reviewed. The authors tabulated data according to year of study, journal, study type, level of evidence, patient demographics, procedure, and outcomes. We found that surgical treatment of internal snapping hip improves patient symptoms in the majority of patients. Endoscopic release is associated with fewer reported complications compared with open release. All studies of endoscopic treatment of internal snapping hip syndrome also performed intra-articular examination and treatment of intra-articular pathology. The incidence of associated intra-articular pathology was reported in 5 of 6 studies. These results suggest that a painful snapping iliopsoas tendon in many cases may be a result of intra-articular hip pathology rather than an independent entity. Early studies suggest no difference in efficacy or associated complications rate when comparing extracapsular to transcapsular iliopsoas tendon release. Further studies are needed comparing operative to nonoperative treatment and methods of determining patients likely to benefit from operative intervention.
我们的目的是评估关于经关节入路切开松解和延长阔筋膜张肌治疗髋关节内弹响综合征的有效性的证据，该方法将阔筋膜张肌松解与关节内病变的治疗相结合。我们对 4 个数据库进行了检索，并对 12 篇关于髋关节内弹响的手术治疗的报告进行了回顾。作者根据研究年份、期刊、研究类型、证据水平、患者人口统计学资料、手术方法和结果进行了数据制表。我们发现，大多数患者的髋关节内弹响的手术治疗可以改善患者的症状。与开放性松解相比，关节镜下松解与更少的报告并发症相关。所有髋关节内弹响综合征的内镜治疗研究都进行了关节内检查和关节内病变的治疗。5 项研究中有 6 项报告了相关的关节内病变。这些结果表明，在许多情况下，疼痛性弹响的阔筋膜张肌肌腱可能是髋关节内病理的结果，而不是独立的实体。早期研究表明，比较关节囊外和关节囊内阔筋膜张肌肌腱松解，在疗效或相关并发症发生率方面没有差异。需要进一步研究比较手术治疗和非手术治疗，以及确定哪些患者可能受益于手术干预的方法。
