Department of Orthopaedic Surgery. Via Gianfranco, University of Turin, Centro Traumatologico Ortopedico (CTO), Zuretti 29, 10126, Turin, Italy.
Department of Orthopaedics and Traumatology, University of Turin CTO, Via Zuretti 29, 10126, Turin, Italy.
Eur J Orthop Surg Traumatol. 2024 Aug;34(6):2835-2844. doi: 10.1007/s00590-024-04030-5. Epub 2024 Jun 14.
Snapping hip syndrome (SHS) is characterized by snapping sensation and pain and affects up to 10% of the general population. External snapping hip syndrome (ESHS), the most common form, is often due to repetitive movements in sports or anatomical predispositions. Conservative treatment includes physiotherapy and corticosteroid injections, while surgery is considered if conservative measures fail. Open surgical techniques carry several risks, while modern arthroscopic techniques offer less invasive options, such as endoscopic iliotibial band release (ITB) and gluteus maximus tenotomy.
A systematic review was conducted adhering to the PRISMA guidelines. Relevant studies were searched in four databases: Pubmed, Scopus, Embase, and Medline. The selected articles were evaluated according to the criteria of levels of evidence. The Risk of Bias In Non-randomized Studies of Interventions (ROBINS-I) was used to analyze the retrospective studies. This paper was registered in the International Prospective Registry of Systematic Reviews (PROSPERO).
Out of 9 included studies, 403 patients with 689 hips underwent endoscopic treatment. ITB release and his variations were the main surgical techniques. Gluteus maximus tenotomy was also used in some studies. Postoperative rehabilitation protocols varied. Patients generally experienced significant improvements in symptoms and functional outcomes, with low rates of recurrence (1.02%) and revision (0.15%). Complications were minimal.
Endoscopic treatment of ESH shows favorable results, improving functional outcomes and returning patients to pre-injury activity levels. Long-term efficacy and costeffectiveness need to be evaluated, emphasizing the importance of large-scale prospective randomized trials to clarify surgery's benefits in refractory ESH cases.
弹响髋综合征（SHS）的特征为弹响声和疼痛，影响多达 10%的普通人群。最常见的外弹响髋综合征（ESHS）通常是由于运动中的反复动作或解剖学倾向所致。保守治疗包括物理疗法和皮质类固醇注射，而如果保守治疗措施失败，则考虑手术。开放式手术技术存在多种风险，而现代关节镜技术提供了微创选择，例如内镜髂胫束松解（ITB）和臀大肌肌腱切断术。
我们按照 PRISMA 指南进行了系统评价。在四个数据库（Pubmed、Scopus、Embase 和 Medline）中搜索相关研究。根据证据水平标准评估所选文章。使用非随机干预研究的风险偏倚（ROBINS-I）分析回顾性研究。本文在国际前瞻性系统评价注册库（PROSPERO）中进行了注册。
在纳入的 9 项研究中，有 403 名患者的 689 髋接受了内镜治疗。ITB 松解及其变体是主要的手术技术。在一些研究中也使用了臀大肌肌腱切断术。术后康复方案有所不同。患者的症状和功能结果通常有显著改善，复发率（1.02%）和翻修率（0.15%）较低。并发症很少见。
ESHS 的内镜治疗效果良好，可改善功能结果并使患者恢复到受伤前的活动水平。需要评估长期疗效和成本效益，强调需要进行大规模前瞻性随机试验，以明确手术在难治性 ESH 病例中的益处。
