仰卧位经大转子间隙由内向外关节镜下髂胫束松解治疗外侧弹响髋的临床研究OA

Objective To investigate the difference in clinical efficacy between arthroscopic iliotibial band release from medial to lateral via the greater trochanteric space in the supine position and conventional subcutaneous iliotibial band release from lateral to medial in the lateral decubitus position for the treatment of external snapping hip.Methods A total of 30 patients with external snapping hip admitted between January 2019 and June 2021 were enrolled in this study.The patients were divid-ed into the greater trochanteric space group and the subcutaneous group according to different treatment methods.The greater trochanteric space group included 15 patients(30 hips),consisting of 6 males and 9 females,aged from 19 to 44 years with a mean of(31.3±10.9)years.They were treated with arthroscopic iliotibial band release from medial to lateral via the greater trochanteric space in the supine position.The subcutaneous group included 15 patients(30 hips),consisting of 6 males and 9 females,aged from 20 to 44 years with a mean of(31.6±11.3)years.They were treated with arthroscopic subcutaneous iliotib-ial band release from lateral to medial in the lateral decubitus position.All patients presented with varying degrees of lateral hip snapping,positive Ober sign,and limited range of motion at admission.A contracture band was palpable over the greater trochanteric region,and some patients were accompanied by varying degrees of hip pain.The modified Harris hip scores(mHHS)and visual analogue scale(VAS)were recorded.The mean unilateral operation time,incision length,blood loss,and complications(subcutaneous ecchymosis,skin depression,hematoma,nerve injury,and infection)were also documented.Re-sults All 30 patients(60 hips)were followed up for 13 to 36 months,with a mean duration of(16.5±4.2)months.No compli-cations such as nerve injury,vascular injury,or wound infection occurred in either group.The mean unilateral operation time was(14.34±1.85)min in the greater trochanteric space group and(27.45±1.96)min in the subcutaneous group.Subcutaneous ecchymosis occurred in 0 and 4 cases,respectively,and skin depression occurred in 0 and 4 cases,respectively.The greater trochanteric space group was superior to the subcutaneous group,and the differences were statistically significant(P＜0.05).There were no statistically significant differences between the two groups in incision length,intraoperative blood loss,postoper-ative VAS scores,or postoperative mHSS scores(P＞0.05).Conclusion With a minimum follow-up period of 1 year,arthro-scopic iliotibial band release via the medial-to-lateral approach in the supine position proves to be a safe,effective,and efficient technique for the management of external snapping hip,and thus is recommended for widespread clinical use.