Abstract：
BACKGROUND: Snapping hip syndrome (SHS) is characterized by snapping sensation and pain and affects up to 10% of the general population. External snapping hip syndrome (ESHS), the most common form, is often due to repetitive movements in sports or anatomical predispositions. Conservative treatment includes physiotherapy and corticosteroid injections, while surgery is considered if conservative measures fail. Open surgical techniques carry several risks, while modern arthroscopic techniques offer less invasive options, such as endoscopic iliotibial band release (ITB) and gluteus maximus tenotomy.
METHODS: A systematic review was conducted adhering to the PRISMA guidelines. Relevant studies were searched in four databases: Pubmed, Scopus, Embase, and Medline. The selected articles were evaluated according to the criteria of levels of evidence. The Risk of Bias In Non-randomized Studies of Interventions (ROBINS-I) was used to analyze the retrospective studies. This paper was registered in the International Prospective Registry of Systematic Reviews (PROSPERO).
RESULTS: Out of 9 included studies, 403 patients with 689 hips underwent endoscopic treatment. ITB release and his variations were the main surgical techniques. Gluteus maximus tenotomy was also used in some studies. Postoperative rehabilitation protocols varied. Patients generally experienced significant improvements in symptoms and functional outcomes, with low rates of recurrence (1.02%) and revision (0.15%). Complications were minimal.
CONCLUSIONS: Endoscopic treatment of ESH shows favorable results, improving functional outcomes and returning patients to pre-injury activity levels. Long-term efficacy and costeffectiveness need to be evaluated, emphasizing the importance of large-scale prospective randomized trials to clarify surgery\'s benefits in refractory ESH cases.
METHODS: A systematic review was conducted adhering to the PRISMA guidelines. Relevant studies were searched in four databases: Pubmed, Scopus, Embase, and Medline. The selected articles were evaluated according to the criteria of levels of evidence. The Risk of Bias In Non-randomized Studies of Interventions (ROBINS-I) was used to analyze the retrospective studies. This paper was registered in the International Prospective Registry of Systematic Reviews (PROSPERO).
RESULTS: Out of 9 included studies, 403 patients with 689 hips underwent endoscopic treatment. ITB release and his variations were the main surgical techniques. Gluteus maximus tenotomy was also used in some studies. Postoperative rehabilitation protocols varied. Patients generally experienced significant improvements in symptoms and functional outcomes, with low rates of recurrence (1.02%) and revision (0.15%). Complications were minimal.
CONCLUSIONS: Endoscopic treatment of ESH shows favorable results, improving functional outcomes and returning patients to pre-injury activity levels. Long-term efficacy and costeffectiveness need to be evaluated, emphasizing the importance of large-scale prospective randomized trials to clarify surgery\'s benefits in refractory ESH cases.
摘要：
背景：快动髋关节综合征（SHS）的特征是快动感觉和疼痛，影响多达10％的普通人群。外部咬合髋关节综合征（ESHS），最常见的形式，通常是由于运动或解剖学倾向中的重复运动。保守治疗包括物理治疗和皮质类固醇注射，而如果保守措施失败，则考虑手术。开放手术技术有几个风险，虽然现代关节镜技术提供了较少侵入性的选择，如内镜下髂胫束带松解术(ITB)和臀大肌张力切开术。
方法：根据PRISMA指南进行系统评价。在四个数据库中搜索了相关研究：Pubmed，Scopus,Embase,Medline根据证据水平标准对所选文章进行评估。非随机干预研究中的偏倚风险（ROBINS-I）用于分析回顾性研究。本文已在国际前瞻性系统审查登记处（PROSPERO）注册。
结果：在9项纳入研究中，403例689髋患者接受内镜治疗。ITB释放和他的变化是主要的手术技术。在一些研究中也使用了臀大肌截割术。术后康复方案各不相同。患者通常经历了症状和功能结果的显着改善，复发率（1.02%）和翻修率（0.15%）低。并发症很少。
结论：ESH的内镜治疗显示出良好的效果，改善功能结局，使患者恢复到损伤前的活动水平。需要评估长期疗效和成本效益，强调大规模前瞻性随机试验的重要性，以阐明手术治疗难治性ESH的益处。
方法：根据PRISMA指南进行系统评价。在四个数据库中搜索了相关研究：Pubmed，Scopus,Embase,Medline根据证据水平标准对所选文章进行评估。非随机干预研究中的偏倚风险（ROBINS-I）用于分析回顾性研究。本文已在国际前瞻性系统审查登记处（PROSPERO）注册。
结果：在9项纳入研究中，403例689髋患者接受内镜治疗。ITB释放和他的变化是主要的手术技术。在一些研究中也使用了臀大肌截割术。术后康复方案各不相同。患者通常经历了症状和功能结果的显着改善，复发率（1.02%）和翻修率（0.15%）低。并发症很少。
结论：ESH的内镜治疗显示出良好的效果，改善功能结局，使患者恢复到损伤前的活动水平。需要评估长期疗效和成本效益，强调大规模前瞻性随机试验的重要性，以阐明手术治疗难治性ESH的益处。
