The hip joint is the body's largest weight-bearing joint, consisting of the femur (thigh bone) and the acetabulum (pelvic socket). The iliotibial band is a ligament that crosses the hip joint and runs down the lateral thigh to the knee, while the trochanteric bursa is a large sac present above the greater trochanter of the femur. The aim of hip endoscopy is to relieve chronic hip pain by making small portal incisions, the location of which depends on the surgeon's preference and the pathology being treated.
External snapping hip syndrome occurs when the iliotibial band snaps over the greater trochanter during hip flexion and extension. In hip endoscopy, a diamond-shaped defect is created in the iliotibial band lateral to the greater trochanter to allow free mobility of the greater trochanter and prevent snapping. The surgery is performed in the peritrochanteric space, outside the hip joint.
Internal snapping hip syndrome occurs when the iliopsoas tendon snaps over the femoral head, usually with hip extension from a flexed position of more than 90 degrees. Endoscopic treatment involves releasing the iliopsoas tendon at the level of the hip joint or its insertion on the lesser trochanter.
Endoscopic procedures are advantageous due to their minimally invasive techniques, which result in minimal trauma to the surrounding tissues, shorter recovery time with minimal post-surgical complications, and greater range of motion with less post-operative pain.