Arthroscopic Management of Soft Tissue Problems Aroud the Hip

Review Article

Austin J Orthopade & Rheumatol. 2015; 2(3): 1023.

Arthroscopic Management of Soft Tissue Problems Aroud the Hip

Parodi D*, Lara J, Haydar MJ and Tobar C

Departamento de Ortopedia y Traumat ología, Universidad Austral de Chile, Chile

*Corresponding author: Parodi D, Department of Ortopedia y Traumat ología, Universidad Austral de Chile, Luis Pasteur 5259, Vitacura, Santiago, Chile

Received: September 23, 2015; Accepted: November 26, 2015; Published: November 27, 2015


Peritrochanteric diseases are recurrent cause of lateral hip pain that usually affects middle age and active women. Despite questionable results, classically they have been treated in a conservative way. Surgical techniques are preferred for those who had unsatisfactory results with conservative treatment. In these patients we have developed an arthroscopic surgical treatment that included the bursa resection and the parcial release of the iliotibial band, showing satisfactory results. This article describes the surgical technique.


With the development of hip arthroscopy, more attention has been focused on peritrochanteric diseases. Despite the questionable results, classic treatment options include therapeutic exercise, physical modalities, several corticosteroid injections, extracorporeal shock wave therapy, and regenerative injection therapies [1,2]. In thirtyfive patients with peritrochanteric disease, that didn´t responded to classic therapy, we have used surgical treatment and they have showed satisfactory results. This article describes the surgical technique that we have used.

Peritrochanteric diseases can be divided in two large groups: Lateral coxa saltans (snapping hip) and Greater trochanteric pain syndrome.

Lateral coxa saltans (Snapping Hip)

Corresponds to a clinical situation in which young patients, between 15 and 25 years old and 9/10 times women, have sliding of tensor fascia lata over the greater trochanter in a voluntary or involuntary form. This snapping occurs when the standing patient makes lateral movement of the hip, an adduction of the extremity, and most of the time during internal rotation. At this moment, the fascia lata goes abruptly from the anterior to posterior position in relation to the greater to chanter, making a visible snapping in the lateral face of the hip. Sometimes, it is accompanied by a clear snapping sound and pain.

In those patients that conservative treatment fails, surgery to release the fascia is proposed. There are multiple surgical techniques for this procedure [3]. The technique that we use is explained as follows.

Iliotibial band release: Technical Iliotibial Band Release from inside to outside

If the procedure is associated with arthroscopy of the medial compartment, we place the patient in supine position over an orthopedic traction table, but without traction ; if not, we place the patient over an operating radio lucid table; so the greater trochanter is identified, and we use the mid-superior and mid-inferior peritrochanteric portals (Figure 1A) [4].