Endoscopic Lesser Trochanter Excision for Ischiofemoral Impingement

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.