Snapping Hip Syndrome: Result of Partial Release and Anterior Transposition of Iliotibial Band

Abstract

Objectives

Snapping hip syndrome has been a known entity for long, but has only recently been studied in detail. It however remains poorly understood and infrequently diagnosed due to the paucity of the condition. As a result, the literature remains scarce and scattered about the management, with most series limited to less than 15 patients. We present our experience in operative and conservative management of this condition in a series of 20 patients. We describe an out patient operative approach involving release and anterior transposition of the posterior half of the iliotibial band.

Methods

Review of results in 20 patients [25 hips] treated operatively over last 12 years after failed conservative treatment.

Results

Dramatic reduction in average visual analog scale and clicking score from 6 and 9 to 0.7 and 0.6, respectively. Significant improvement in quality of life score from 5 to 9 postoperatively [out of a maximum of 10]. All the patients reported good to excellent relief in symptoms postoperatively and walking distance was no longer limited by hip pain or clicking. Five patients had bilateral surgery and the rest replied in affirmative when asked if they would prefer this procedure in future if the other hip became symptomatic.

Conclusions

We did not have any major complications after the procedure and had a high satisfaction rate of 95 percent. None of the patients have needed a repeat surgery yet. Most patients reported impressive relief in their snapping symptoms, but pain relief was variable. This approach has yielded satisfactory and reproducible results and we would recommend this approach in snapping hip refractory to conservative treatment.

Keywords:

• Snapping hip
• iliotibial band
• anterior transposition
• clicking hip
• trachanteric bursitis

ACKNOWLEDGMENTS

We are very grateful to Mr Steve Carter, extended scope physiotherapist; Ms Sarah Bell, medical secretary; and Dr Shikha Chandak, foundation doctor for help with various aspects of this study.