[Arthroscopic decompression of extra-articular subspinal hip impingement].

OBJECTIVE: Complete arthroscopic decompression of the impinging subspinal soft tissues and resection of the hypertrophic bone formation between the anterior hip capsule and the anterior inferior iliac spine (AIIS) or decompression of a hypertrophic AIIS. INDICATIONS: Painful anterior hip impingement and decreased hip flexion following a hypertrophic osseous subspinal deformation. CONTRAINDICATIONS: No clinical symptoms or decreased anterior hip function despite radiological osseous subspinal hip impingement. SURGICAL TECHNIQUE: Hip arthroscopy in supine position on an extension table. Treatment of possible intraarticular hip pathologies in the central or peripheral compartment. Arthroscopic visualization of the hypertrophic impinging soft tissues below the AIIS and decompression using a shaver or radiofrequency device. Complete arthroscopic resection of the hypertrophic AIIS parts and the osseous subspinal deformation using a high speed burr under fluoroscopic control. POSTOPERATIVE MANAGEMENT: Early functional rehabilitation with full weight-bearing and unlimited hip motion; 3 weeks ossification prophylaxis and 8 weeks of limitation for jumping and running sports activities.
RESULTS: There are no comparative studies or medium- and long-term study results in the literature for arthroscopic AIIS decompression. However, currently published case series show an improvement of the determined scores.