Endoscopic Peritrochanteric Space: Evaluation and Treatment

Abstract

A thorough understanding of the anatomy and biomechanics of the hip will help in the evaluation and treatment of lateral-based hip pain. The peritrochanteric space involves all the osseous, musculotendinous, neurovascular, and kinematic chain of the hip joint. Peritrochanteric space disorders include patients with trochanteric bursitis, external coxa saltans (or external snapping hip), and gluteus medius and minimus tears. As part of a comprehensive standardized physical examination, a lateral-based hip pain evaluation will guide the examiner toward a differential diagnosis. Conservative therapy is the first line of treatment; however endoscopic surgical intervention can provide pain relief and a return to normal function in cases of recalcitrant peritrochanteric problems. Key aspects of the clinical examination, peritrochanteric space pathology, peritrochanteric space anatomy, and endoscopic navigation and treatment are described in this chapter.