Arthroscopic release through the peritrochanteric compartment from inside-out in the treatment of lateral snapping hip
10.3760/cma.j.cn121113-20230803-00068
- VernacularTitle:关节镜下经转子周围间室由内向外松解术治疗外侧型弹响髋
- Author:
Qi GUO
1
;
Xupeng WANG
;
Ming LI
;
Zhenlei LIANG
;
Ning LIU
Author Information
1. 河南大学附属郑州市骨科医院运动医学科,郑州 450052
- Keywords:
Hip joint;
Arthroscopy;
Myofascial release therapy
- From:
Chinese Journal of Orthopaedics
2023;43(23):1573-1579
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical effect of arthroscopic release through the peritrochanteric compartment from inside-out in the treatment of lateral snapping hip.Methods:A total of 38 patients (70 hips) with lateral snapping hip who underwent arthroscopic surgery in Department of Sports Medicine, Zhengzhou Orthopaedics Hospital Affiliated to Henan University from December 2016 to December 2022 were retrospectively analyzed. There were 13 males and 25 females, aged 27.8±7.6 years (range, 15-45 years). Among them 6 cases of unilateral and bilateral 32 cases. According to the different release approaches, they were divided into outside-in group (37 hips) and inside-out group (33 hips). Visual analogue scale (VAS) was used to evaluate postoperative hip pain, and gluteal muscle contracture disability scale (GDS) was used to evaluate postoperative effectiveness. Postoperative hip function was evaluated by modified Harris hip score (mHHS).Results:All patients in the two groups successfully completed the operation and were followed up for 8.23±1.25 months (range, 6-12.8 months). The hip VAS scores in the inside-out group were 4.0 (3.5, 6.0), 5.0 (4.0, 6.0), and 1.0 (0.5, 1.0) before surgery, 1 week after surgery, and 3 months after surgery, respectively, and those in the outside-in group were 4.0 (3.5, 6.0), 5.0 (4.0, 6.0), and 1.0 (0.5. 1.0), and the differences between the two groups of patients in the within group comparison of hip VAS before and after surgery were statistically significant ( P<0.05). The hip VAS at 3 months postoperatively was smaller than that before surgery and at 1 week postoperatively, and the differences were statistically significant ( P<0.05). There were no significant differences between groups at different time points ( P>0.05). The GDS scores in the inside-out group were 52.30±8.19, 75.03±6.41, and 92.30±4.61 preoperatively, 1 week postoperatively, and 3 months postoperatively, respectively, and in the outside-in group were 51.97±6.64, 75.41±7.10, and 91.32±4.18, respectively, and the differences in the quantitative GDS function scores of the hips in the pre- and postoperative periods of the patients in both groups were statistically significant ( P<0.05). The differences in the quantitative GDS function scores within the groups were statistically significant ( P<0.05), and the quantitative GMC function scores of the hip joints at 3 months after surgery were greater than those of the preoperative period and 1 week after surgery, and the differences were statistically significant ( P<0.05). There were no significant differences between groups at different time points ( P>0.05). Differences in mHHS within group comparisons before and after surgery were statistically significant in both groups ( P<0.05), and mHHS at 3 months postoperatively was greater than preoperatively and 1 week postoperatively, with statistically significant differences ( P<0.05). The mHHS at 1 week postoperatively in the inside-out group was 79.03±7.37, which was greater than that in the outside-in group 71.32±10.02, and the difference was statistically significant ( t=3.63, P<0.001). Conclusion:Arthroscopic release through the peritrochanteric compartment from inside-out in the treatment of lateral snapping hip can effectively reduce hip pain and improve hip function, with satisfactory clinical results, and can be used as an alternative treatment to inward-to-outward release.