Clin Orthop Surg.  2017 Dec;9(4):529-533. 10.4055/cios.2017.9.4.529.

Ischiofemoral Impingement Syndrome: Outcomes of Endoscopic Resection of the Lesser Trochanter

• Hernandez
• Haddad S
• Nuñez JH
• Gargallo-Margarit A
• Sallent A
• Barro V

• KMID: 2412255
• DOI: http://doi.org/10.4055/cios.2017.9.4.529

Abstract

Ischiofemoral impingement syndrome is a rare clinical entity characterized by chronic groin, buttock or hip pain associated with radiographic evidence of narrowing of the space between the lesser femoral trochanter and the ischial tuberosity. Introduction of magnetic resonance imaging to the clinical practice as well as the establishment of the radiological definition of the abnormal ischiofemoral distance has led to an increasing interest in this condition. Ischiofemoral impingement syndrome is a poorly understood disorder of chronic pain, especially regarding its treatment. The authors present two cases of primary ischiofemoral impingement syndrome successfully treated with a minimally invasive surgical technique. With this endoscopic technique, it was possible to resect the lesser trochanter and restore the ischiofemoral space. Immediate clinical and functional improvement was reported by both patients.

Keyword

Hip joint surgery; Arthroscopic surgery; Lesser trochanter

MeSH Terms

Adult
Endoscopy/*methods
Female
Femur/diagnostic imaging/*surgery
Humans
Ischium/*diagnostic imaging
Magnetic Resonance Imaging
Middle Aged
Musculoskeletal Diseases/diagnostic imaging/*surgery
Syndrome

Figure

• 

  Fig. 1 Preoperative and 1-year follow-up magnetic resonance imaging of case 1. (A) Axial T2 sequence showing narrowing of both ischiofemoral spaces with hyperintense signal at the right quadratus femoris and slight displacement of the sciatic nerve. (B) Axial T2 sequence showing improvement in the right ischiofemoral space with persistent narrowing of the left space.

• 

  Fig. 2 Surgical sequence in case 2. (A) The lesser trochanter and the intact iliopsoas tendon as seen intraoperatively. (B) Shaving and radiofrequency coagulation of the lesser trochanter. (C) Lesser trochanter resection with a burr probe. (D) Final aspect of the procedure with the cancellous bone exposed.

• 

  Fig. 3 Pre- and postoperative X-rays of case 1. Preoperative (A) and postoperative (B) anteroposterior pelvic X-rays showing complete resection of the lesser trochanter.

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