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Lateral Snapping Hip: Ultrasonographic-Guided Surgery

March 01, 2020

Contributors: Alvaro Iborra Sr, DPM; Pablo Sanz Ruiz, MD, PhD; Manuel Villanueva, MD, PhD

Snapping hip is a condition in which an audible or tactile snapping sensation occurs in the hip when walking, running, rising from a chair, or swinging the leg. In most patients, snapping is caused by the movement of a muscle or tendon over a bony structure in the hip. For most patients, the only symptom is a snapping sensation; however, dancers or athletes may experience pain or locking, leading to disability. Lateral snapping hip is the most frequent type of snapping hip and is caused by excessive tension of the iliotibial band over the greater trochanter. Snapping hip may be intra-articular or extra-articular. The most common cause of snapping hip occurs when the iliotibial band crosses over the greater trochanter. The causes of snapping hip may be morphologic or anatomic. Lateral snapping hip syndrome is characterized by a palpable snap in the peritrochanteric region during flexion and extension of the hip. Patients with lateral snapping hip syndrome may be asymptomatic or may have pain, swelling of the bursa over the greater trochanter, and locking sensations leading to disability. This video demonstrates ultrasonographic-guided release of the proximal iliotibial band. Our preliminary studies in cadaver models and patients have shown that the procedure is safe and effective. Ultrasonographic-guided release of the iliotibial band is a novel form of surgery for the management of lateral snapping hip that is minimally aggressive and potentially results in a faster recovery. Ultrasonographic-guided release of the iliotibial band allows surgeons to decrease the size of the incision and may be performed under local anesthesia in an outpatient setting. The procedure is relatively quick and painless. Few complications occurred, and no contraindications to the procedure exist.

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