Prospective Randomized Study of Two Different Techniques for Endoscopic Iliopsoas Release in the Treatment of Internal Snapping Hip Syndrome (SS-06)

Abstract

We compare 2 randomized groups of patients that were prospectively followed, treated for internal snapping hip symptoms using two different endoscopic techniques. Sort term results are presented. To evaluate short term results of two different techniques of endoscopic iliopsoas tendon release for the treatment of internal snapping hip syndrome. Between January 2005 and January 2007 a consecutive series of patients with the diagnosis of internal snapping hip syndrome was treated with endoscopic release of the iliopsoas tendon. The patients were randomized in two different groups. Patients in group one were treated with endoscopic iliopsoas tendon release at the lesser trochanter and patients in group two were treated with endoscopic transscapsular psoas release from the peripheral compartment. Hip arthroscopy of both the central and peripheral compartment was performed in both groups using the lateral approach. Associated injuries were identified and treated arthroscopically. Postoperative physical therapy was the same for both series and every patient received 400mg of celecoxib daily for 21 days after surgery. Preoperative and postoperative WOMAC scores and imaging studies were evaluated. Nineteen patients were included in the study, 10 in group 1, 5 male and 5 female with an average age of 29.5 years and 9 in group 2, 8 female and 1 male with an average age of 32.6 years. No statistical difference was found in group composition. Associated injuries were found and treated in 8 patients in group 1 and 7 patients in group 2. No statistical difference was found between groups in preoperative WOMAC scores, every patient en both groups presented an increment in the WOMAC score. Increments in WOMAC scores were statistically significant in both groups, no difference was found in postoperative WOMAC results between groups. No complications were seen. Different techniques for endoscopic release of the iliopsoas tendon have been recently described in the literature, we compared both techniques in prospectively in 2 series of patients that were randomized and found no difference in short-term results or complication incidence.