Extra-articular soft-tissue impingement of the hip joint Izvanzglobni sindrom sraza u području kuka

medicina fluminensis 2015, Vol. 51, No. 1, p. 145-153 145 Abstract. Conservative therapy is the gold standard for treatment of painful extra-articular snapping abnormalities of the hip. If these treatments are not successful, surgical interventions may be necessary. Arthroscopic tenotomy, bursectomy or tract release may be indicated. In addition to open techniques, various arthroscopic techniques have been described. Iliopsoas tendon impingement following a complete hip replacement is a new syndrome that has been described. This involves an atypical tear of the labrum at the anterior rim of the acetabulum. Arthroscopic tenotomy is an excellent alternative here to the complex hip-socket replacement with good results and fewer complications than acetabular cup replacement. The therapy involves arthroscopic refixation of the labrum using suture anchors and tenotomy of the psoas tendon. Open or arthroscopic procedures are recommended for performing a bursectomy or a tract release in the trochanter region. There are currently no comparative studies. Arthroscopic psoas tendon tenotomy is an effective method for treating internal snapping hip and mechanical psoas irritation after THR if conservative treatment fails. The scientific evidence in other extra-articular abnormalities of the hip remains poor. Bursectomies and tract release in external snapping hip can be carried out using open and arthroscopic techniques with similar outcomes.