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Related Concept Videos

Muscles that Move the Thigh01:20

Muscles that Move the Thigh

The thigh's motion is primarily governed by muscles originating in the pelvic girdle and inserted into the femur. One crucial muscle, the iliopsoas, is a combination of the psoas major and the iliacus muscles, sharing a common insertion point on the lesser trochanter of the femur.
Three other significant muscles are the gluteus maximus, gluteus medius, and gluteus minimus. The gluteus maximus originates from the posterior surface of the ilium, sacrum, and coccyx, and the thoracolumbar fascia...

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Endoscopic Lesser Trochanter Excision for Ischiofemoral Impingement.

Devon E Anderson1, Elizabeth J Scott1, R Chad Mather1

  • 1Duke Sports Sciences Institute, Duke University, Durham, North Carolina, USA.

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|May 1, 2025
PubMed
Summary

Ischiofemoral impingement (IFI) is a hip pain cause. Endoscopic lesser trochanter excision via a posterior approach safely and effectively treats IFI by increasing hip space and relieving sciatic nerve compression.

Keywords:
hip arthroscopyischial tunnel syndromeischiofemoral impingementlesser trochanter excisionsciatic nerve

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Hip Arthroscopy

Background:

  • Ischiofemoral impingement (IFI) is an underrecognized cause of posterior hip, low back, and deep gluteal pain.
  • Anatomical factors such as femoral anteversion and pelvic tilt contribute to IFI symptoms.

Purpose of the Study:

  • To describe and evaluate a preferred surgical technique for treating ischiofemoral impingement.
  • To assess the safety and efficacy of endoscopic lesser trochanter excision for IFI.

Main Methods:

  • The study details an endoscopic lesser trochanter (LT) excision using a posterior approach in the prone position.
  • Key steps include sciatic nerve protection, radiofrequency dissection, and LT burr excision.
  • Patients are managed with touch-down weightbearing for six weeks post-surgery.

Main Results:

  • Endoscopic LT excision reliably increases the ischiofemoral distance.
  • The technique effectively relieves mechanical bone impingement and sciatic nerve entrapment.
  • The posterior approach provides optimal visualization for neurovascular structure protection and complete LT excision.

Conclusions:

  • Posterior endoscopic LT excision is a safe and effective surgical treatment for ischiofemoral impingement.
  • The technique ensures sciatic nerve visualization and complete removal of the lesser trochanter.