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\nTo 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.\n\n\nMETHODS\nRetrospective review case series with both FAI syndrome and ESH who underwent surgical treatment under same indications. According to the primary operation that determined by patients themselves, the patients undergoing ITB release during hip arthroscopy for FAI syndrome were enrolled in ITB-R group, the 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. Patient-reported outcomes (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 (MCID), patient acceptable symptomatic state (PASS) and substantial clinical benefit (SCB) for the PROs at 2 years operatively were comparative analyzed.\n\n\nRESULTS\nThe prevalence of ESH in FAI syndrome patients 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 two years postoperatively (P=0.013, 0.016, 0.002 and 0.005, respectively). The rates of achieving PASS for mHHS, PASS for VAS-pain and SCB for iHOT-33 of patients in ITB-R group were significantly better than that in Non-ITB-R group (P=0.009, 0.006 and 0.027, respectively).results CONCLUSIONS: Patients with both FAI syndrome and ESH undergoing ITB release during hip arthroscopy had better PROs than those undergoing hip arthroscopy without ITB releaseconclusion.