Endoscopic Treatment of External Coxa Saltans (Snapping Hip) in the Supine Position.

Abstract

External coxa saltans, or "snapping hip," is present in about 5% of the population and typically stems from a tight iliotibial band (ITB) passing over the greater trochanter. For patients who have been unresponsive to nonoperative treatments, endoscopic ITB release can be effective in relieving symptoms. Various techniques have been described, including those involving lateral decubitus positioning, alternative portal placement, and outside-in release of the ITB. In this technique, we describe an endoscopic partial ITB release for external coxa saltans using supine positioning, standard hip arthroscopy portals, and inside-out release from the peritrochanteric space, which allows treatment of concomitant intra-articular pathology and direct visualization of the posterior undersurface of the ITB for a more precise release of the involved pathologic tissue.