Endoscopic Iliotibial Band Release During Hip Arthroscopy for Femoroacetabular Impingement Syndrome and External Snapping Hip Had Better Patient-Reported Outcomes: A Retrospective Comparative Study

Abstract

Purpose: To compare patient-reported outcomes (PROs) in patients with femoroacetabular impingement (FAI) syndrome and external snapping hip (ESH) treated with hip arthroscopy with or without endoscopic iliotibial band (ITB) release.

Methods: Retrospective review case series with both FAI syndrome and ESH who underwent surgical treatment under same indications. According to the primary operation that was determined by patients themselves, the patients undergoing ITB release during hip arthroscopy for FAI syndrome were enrolled in the ITB-R group, and patients undergoing hip arthroscopy without ITB release were enrolled in non-ITB-R group. Patients with dysplasia, severe osteoarthritis, revision, and bilateral surgery were excluded. PROs including international Hip Outcome Tool (iHOT-33), modified Harris Hip Score (mHHS), visual analog scale for pain (VAS-pain) and VAS-satisfaction, and the rates of achieving minimal clinically important difference, patient acceptable symptomatic state (PASS), and substantial clinical benefit for the PROs at 2 years operatively were comparative analyzed.

Results: The prevalence of ESH in patients with FAI syndrome who underwent hip arthroscopy in our institution was 4.9% (30 of 612 hips). The mean age at the time of surgery was 33.1 ± 6.9 years (range 22-48 years). After exclusion, 16 patients (16 hips) were enrolled into ITB-R group and 11 patients (11 hips) enrolled into non-ITB-R group. PROs including iHOT-33, mHHS, VAS-pain, and VAS-satisfaction in patients in ITB-R group were better than that in non-ITB-R group at 2 years postoperatively (P = .013, .016, .002, and .005, respectively). The rates of achieving PASS for mHHS, PASS for VAS-pain, and substantial clinical benefit for iHOT-33 of patients in ITB-R group were significantly better than that in non-ITB-R group (P = .009, .006, and .027, respectively).

Conclusions: Patients with both FAI syndrome and ESH undergoing ITB release during hip arthroscopy had better PROs than those undergoing hip arthroscopy without ITB release.

Level of evidence: Level III, retrospective comparative study.