Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original Article With Video IllustrationDiagnosis and 2-Year Outcomes of Endoscopic Treatment for Ischiofemoral Impingement
Section snippets
Methods
The reports of 144 patients who consecutively underwent hip arthroscopic and endoscopic procedures between August 2011 and January 2012 were retrospectively reviewed. The inclusion criteria were patients who had a diagnosis of IFI and who underwent endoscopic partial resection of the lesser trochanter. The exclusion criteria were patients with isolated intra-articular pathology or less than 2 years of follow-up. Five patients (5 hips) met the inclusion criteria, and no patient was excluded.
Results
All 5 patients complained of deep gluteal pain and limitation when performing physical activities before surgery. The mean duration of symptoms until surgery was 29.2 months (range, 5 to 66 months) (Table 1). All patients had undergone consultations with 4 or more orthopaedic surgeons before the diagnosis, although no history of surgery of the hip was present in any patient. The mean ischiofemoral space was 8.9 mm (range, 2.3 to 13.2 mm) and the mean quadratus femoris space was 6.1 mm (range,
Discussion
The endoscopic treatment of IFI successfully improved the functional scores in all 5 patients in this study at a minimum follow-up of 2 years. There are only a few published studies of surgical treatment for correction of IFI.1, 6, 7, 8, 9 Johnson1 was the first author to describe lesser trochanter resection through an open approach. In 2 patients IFI was due to total hip arthroplasty. The third patient presented with impingement after a proximal femoral osteotomy, and lesser trochanter
Conclusions
The endoscopic treatment of IFI was effective at 2 years in 5 patients with consistent clinical and imaging diagnostic findings.
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2021, Arthroscopy - Journal of Arthroscopic and Related SurgeryCitation Excerpt :Patients were assessed before surgery and at the most recent follow-up with the modified Harris hip score (mHHS) and Oswestry disability index (ODI).23,24 The diagnosis of LTI was based on the following clinical and imaging findings: presence of hip pain, pain on palpation of the ischiofemoral space, positive ischiofemoral impingement test, positive long stride walking test with pain relief by walking in hip abduction, and decreased ischiofemoral space (<17 mm) at controlled magnetic resonance imaging (MRI).20,21,25 The surgical indication also was based on a positive hip–spine extension test: hip extension limitation with a firm endpoint impeding extension beyond zero degrees in neutral abduction–adduction and rotation, resulting in pelvic and lumbar pain with compensatory motion in the sagittal plane, which was relieved by extending the hip in abduction (Fig 1).
MRI 3D simulation of hip motion in female patients with and without ischiofemoral impingement
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The authors report the following potential conflict of interest or source of funding: H.D.M. receives support from Smith & Nephew and owns stock in Pivot Medical.