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Pain relief and good functional outcomes after hip endoscopy via posterior approach in patients with ischiofemoral impingement

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Ischiofemoral impingement is considered to be an uncommon and difficult pathology to diagnose with respect to hip pain etiology. The objective was to describe the clinical results of endoscopic lesser trochanter resection via a posterior approach in patients with Ischiofemoral impingement.

Methods

This was a retrospective observational study of consecutive patients with Ischiofemoral impingement, who underwent endoscopic resection of the lesser trochanter via a posterior approach, between 2015 and 2018. Clinical results were evaluated using the ischiofemoral impingement test, long-stride walking test, modified Harris Hip Score (mHHS) and the Oxford scale to assess the strength of the iliopsoas muscle as well as the presence of complications. Preoperative and postoperative ischiofemoral space was measured to assess whether the resection of the lesser trochanter was adequate.

Results

16 hips in 13 patients (mean age: 34.4 ± 12.1 years, 11 women) with a follow-up period between 24 and 59 months were included. Preoperative ischiofemoral space ranged from 6.4 to 22.4 mm, a measure > 17.0 mm was achieved in 15 hips without the presence of pain in IFI test and long-strides walking test. Function improved postoperatively, as reflected by a higher mean mHHS (preoperative: 44.6 ± 21.5, postoperative: 81.2 ± 15.1, p < 0.05). After surgery, the strength of the iliopsoas muscle was not decreased compared to the preoperative measure. Three complications were reported, including two cases that required revision surgery.

Conclusions

Endoscopic resection of the lesser trochanter via posterior approach provides satisfactory outcomes with symptom relief and good functional results in patients with Ischiofemoral impingement. It is important to discuss the benefits and risks when offering this treatment choice.

Level of Evidence

Level IV

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Acknowledgements

The authors thank Mónica Morales and Dr. Ricardo Alzate, as well as the Research Institute of Centro Médico Imbanaco for their support during the development of this project.

Funding

This research did not receive any financial support from funding agencies.

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Authors and Affiliations

  1. Hip Preservation Unit, Institute of Osteoarticular Diseases, Centro Médico Imbanaco, Carrera 38A, No. 5a-100, Tower A-Office 105, Cali, Colombia

    Bernardo Aguilera-Bohórquez, Mario Leiva, Julio Pacheco, Daniela Calvache & Miguel Fernandez

  2. Fellow of Preservation Surgery and Hip Endoscopy, Pontificia Universidad Javeriana Cali, Cali, Colombia

    Mario Leiva, Julio Pacheco & Miguel Fernandez

  3. Institute of Statistics, Universidad de Valparaiso, Valparaiso, Chile

    Erika Cantor

Authors
  1. Bernardo Aguilera-Bohórquez
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  2. Mario Leiva
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  4. Daniela Calvache
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  5. Miguel Fernandez
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  6. Erika Cantor
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Contributions

BA-B, MF and EC made the design of the study. ML, JP and DC recollected the data from the clinical records. BA-B, EC helped with the statistical analysis. The interpretation of the statistical results was made by all authors. BA-B and EC drafted the manuscript with ML, JP, MF and DC. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Bernardo Aguilera-Bohórquez.

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Conflict of interest

The authors have no conflict of interest to declare.

Ethics approval

This study was approved by the institutional review board of the corresponding author`s hospital.

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Aguilera-Bohórquez, B., Leiva, M., Pacheco, J. et al. Pain relief and good functional outcomes after hip endoscopy via posterior approach in patients with ischiofemoral impingement. Knee Surg Sports Traumatol Arthrosc 29, 2394–2400 (2021). https://doi.org/10.1007/s00167-020-06309-6

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  • DOI: https://doi.org/10.1007/s00167-020-06309-6

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