External Snapping Hip Treated by Effective Designed N-plasty of the Iliotibial Band / 대한고관절학회지

PURPOSE: The purpose of this study is to present the effective design of N-plasty of the iliotibial band and surgical results of its use as a treatment for refractory external snapping hip. MATERIALS AND METHODS: We evaluated 17 patients (24 cases) with external snapping hip who underwent N-plasty between October 2013 and May 2016 and who were followed up for at least 12 months. All patients were male and the mean age was 20.8 years. The mean duration of symptoms prior to surgical intervention was 28.5 months with an average follow up of 24.5 months. Surgery was defined as being successful when patients could carry out their daily activities and exercise without a clicking sensation or pain 6 months after surgery until their last follow-up. Failure was defined when either a clicking sensation or pain was present. The visual analog scale (VAS) and modified Harris hip score (mHHS) were measured and compared preoperatively and at last follow-up. RESULTS: All patients had complete resolution of pain and snapping. The VAS decreased from 6.77 preoperatively to 0.09 postoperatively and mHHS improved from 69.5 to 97.8 after surgery. CONCLUSION: Modified designed N-plasty is considered to be an excellent treatment method facilitating operation reproducibility with maximum elongation effect of the iliotibial band.

External Snapping Hip Treated by Effective Designed N-plasty of the Iliotibial Band / 대한고관절학회지

PURPOSE: The purpose of this study is to present the effective design of N-plasty of the iliotibial band and surgical results of its use as a treatment for refractory external snapping hip. MATERIALS AND METHODS: We evaluated 17 patients (24 cases) with external snapping hip who underwent N-plasty between October 2013 and May 2016 and who were followed up for at least 12 months. All patients were male and the mean age was 20.8 years. The mean duration of symptoms prior to surgical intervention was 28.5 months with an average follow up of 24.5 months. Surgery was defined as being successful when patients could carry out their daily activities and exercise without a clicking sensation or pain 6 months after surgery until their last follow-up. Failure was defined when either a clicking sensation or pain was present. The visual analog scale (VAS) and modified Harris hip score (mHHS) were measured and compared preoperatively and at last follow-up. RESULTS: All patients had complete resolution of pain and snapping. The VAS decreased from 6.77 preoperatively to 0.09 postoperatively and mHHS improved from 69.5 to 97.8 after surgery. CONCLUSION: Modified designed N-plasty is considered to be an excellent treatment method facilitating operation reproducibility with maximum elongation effect of the iliotibial band.

Surgical Treatment of Snapping Hip by Modified Z-plasty of the Iliotibial Band / 대한스포츠의학회지

We performed modified Z-plasty (N-plasty) in the patients with snapping hip syndrome arising from the iliotibial band whose pain and clicking sensation persisted despite conservative treatments. We analyzed clinical results to evaluate the effectiveness of this new technique. Among 51 patients (65 cases) who still felt pain and reported clicking sensation during daily life despite hospitalization for at least 2 months from January 1999 to November 2011, we evaluated a total of 32 patients (37 cases) who underwent N-plasty and followed up for more than 6 months. All patients were male whose average age was 24 years. Initial symptoms developed an average of 10 months before hospital visit. Surgery was defined success by postoperative 6 months at which time the patient could be able to carry on with daily life and to exercise without clicking sensation and pain, and defined failure when either clicking sensation or pain was present. We observed that the posterior portion of the iliotibial band was thickened by an average of 8.4 mm. Tenotomy of the iliotibial band lengthened the band by an average of 23mm and narrowed the width of the iliotibial band anterior to posterior. Success was in 33 cases (89%) after surgery. Failure was observed in 4 cases. Three were improved after resurgery and 1 was treated conservatively. We found that N-plasty performed in external type snapping hip patients was an effective method yielding a high success rate.

The Surgical Treatment of External Snapping Hip by Modified Z-plasty (N-plasty) of the Iliotibial Band

PURPOSE: Modified Z-plasty(N-plasty) was performed on patients with snapping hip syndrome arising from the iliotibial band, whose pain and clicking sensation persisted despite conservative treatment. The effectiveness of this new technique was evaluated from an analysis of the clinical results. MATERIALS AND METHODS: Among the 44 patients (58 cases), who still felt pain and reported a clicking sensation during daily life despite hospitalization for at least 2 months from January 1999 to August 2007, this study evaluated a total of 25 patients (30 cases) who underwent N-plasty and were followed up for more than 6 months. All patients were male with a mean age of 21 years. The initial symptoms developed an average of 11.5 months prior to the hospital visit (range, 1 month to 4 years). The affected side was the right side in 6 cases and the left in 10. Among 9 patients affected bilaterally, 5 patients (10 cases) underwent surgery on both sides, 1(1 case) on the right side, and 3 (3 cases) on the left side. Surgery was defined as being successful when at 6 months after surgery the patient could carry out their daily activities and exercise without a clicking sensation or pain. Failure was defined when either a clicking sensation or pain was present. RESULTS: The posterior portion of the iliotibial band was thickened by an average of 8.9 mm (range, 6~14 mm). A tenotomy of the iliotibial band lengthened the band by an average of 25 mm (range, 20~35 mm) and narrowed the width of the iliotibial band anterior to posterior. Twenty-nine cases (97%) had a successful outcome after surgery. Recurrence occurred in 1 case. After additional surgery, the recurrence was found to be due to the insufficient length of the tenotomy. CONCLUSION: N-plasty performed in external type snapping hip patients is an effective method with a high success rate.