Hip & pelvis

The Korean Hip Society (대한고관절학회)
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Stress Fracture after Arthroscopic Lesser Trochanter Resection: Diagnosis and Therapy

  • Matthieu Baert (Department of Orthopaedic Surgery, AZ Sint-Lucas) ;
  • Maxence Vandekerckhove (Department of Orthopaedic Surgery, AZ Sint-Lucas) ;
  • Jan Vanlommel (Department of Orthopaedic Surgery, AZ Sint-Lucas)
  • Received : 2022.08.25
  • Accepted : 2023.05.11
  • Published : 2024.03.01
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Abstract

We report on the case of a 52-year-old female who presented with a stress fracture after undergoing an endoscopic resection of the lesser trochanter in ischiofemoral impingement, which was resistant to maximal conservative treatment. To the best of our knowledge, this complication has not been previously described. Non-weight-bearing and intravenous alendronic acid were prescribed for management. No additional surgery was required. The patient was pain free with the ability to perform sports on the same level as before and had no complaints.

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References

  1. Gollwitzer H, Banke IJ, Schauwecker J, Gerdesmeyer L, Suren C. How to address ischiofemoral impingement? Treatment algorithm and review of the literature. J Hip Preserv Surg. 2017;4:289-98. https://doi.org/10.1093/jhps/hnx035
  2. Safran M, Ryu J. Ischiofemoral impingement of the hip: a novel approach to treatment. Knee Surg Sports Traumatol Arthrosc. 2014;22:781-5. https://doi.org/10.1007/s00167-013-2801-8
  3. Jo S, O'Donnell JM. Endoscopic lesser trochanter resection for treatment of ischiofemoral impingement. J Hip Preserv Surg. 2015;2:184-9. https://doi.org/10.1093/jhps/hnv019
  4. Corrales R, Mediavilla I, Margalet E, Aramberri M, Murillo-Gonzalez JA, Matsuda D. Endoscopic lesser trochanter resection with refixation of the iliopsoas tendon for treatment of ischiofemoral impingement. Arthrosc Tech. 2018;7:e321-5. https://doi.org/10.1016/j.eats.2017.09.010
  5. Nakano N, Shoman H, Khanduja V. Treatment strategies for ischiofemoral impingement: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2020;28:2772-87. https://doi.org/10.1007/s00167-018-5251-5
  6. Truong WH, Murnaghan ML, Hopyan S, Kelley SP. Ischioplasty for femoroischial impingement: a case report. JBJS Case Connect. 2012;2:e51. https://doi.org/10.2106/JBJS.CC.K.00177
  7. Ilizaliturri VM Jr, Camacho-Galindo J. Endoscopic treatment of snapping hips, iliotibial band, and iliopsoas tendon. Sports Med Arthrosc Rev. 2010;18:120-7. https://doi.org/10.1097/JSA.0b013e3181dc57a5
  8. Johnson KA. Impingement of the lesser trochanter on the ischial ramus after total hip arthroplasty. Report of three cases. J Bone Joint Surg Am. 1977;59:268-9.
  9. Stenhouse G, Kaiser S, Kelley SP, Stimec J. Ischiofemoral impingement in children: imaging with clinical correlation. AJR Am J Roentgenol. 2016;206:426-30. https://doi.org/10.2214/AJR.15.14909
  10. Hernandez A, Haddad S, Nunez JH, Gargallo-Margarit A, Sallent A, Barro V. Ischiofemoral impingement syndrome: outcomes of endoscopic resection of the lesser trochanter. Clin Orthop Surg. 2017;9:529-33. https://doi.org/10.4055/cios.2017.9.4.529
  11. Ganz R, Slongo T, Turchetto L, Masse A, Whitehead D, Leunig M. The lesser trochanter as a cause of hip impingement: pathophysiology and treatment options. Hip Int. 2013;23 Suppl 9:S35-41. https://doi.org/10.5301/hipint.5000063
  12. Ali AM, Teh J, Whitwell D, Ostlere S. Ischiofemoral impingement: a retrospective analysis of cases in a specialist orthopaedic centre over a four-year period. Hip Int. 2013;23:263-8. https://doi.org/10.5301/hipint.5000021
  13. Viala P, Vanel D, Larbi A, Cyteval C, Laredo JD. Bilateral ischiofemoral impingement in a patient with hereditary multiple exostoses. Skeletal Radiol. 2012;41:1637-40. https://doi.org/10.1007/s00256-012-1488-0
  14. Audenaert EA, Duquesne K, De Roeck J, et al. Ischiofemoral impingement: the evolutionary cost of pelvic obstetric adaptation. J Hip Preserv Surg. 2021;7:677-87. https://doi.org/10.1093/jhps/hnab004
  15. Torriani M, Souto SC, Thomas BJ, Ouellette H, Bredella MA. Ischiofemoral impingement syndrome: an entity with hip pain and abnormalities of the quadratus femoris muscle. AJR Am J Roentgenol. 2009;193:186-90. https://doi.org/10.2214/AJR.08.2090
  16. Gomez-Hoyos J, Martin RL, Schroder R, Palmer IJ, Martin HD. Accuracy of 2 clinical tests for ischiofemoral impingement in patients with posterior hip pain and endoscopically confirmed diagnosis. Arthroscopy. 2016;32:1279-84. https://doi.org/10.1016/j.arthro.2016.01.024
  17. Singer AD, Subhawong TK, Jose J, Tresley J, Clifford PD. Ischiofemoral impingement syndrome: a meta-analysis. Skeletal Radiol. 2015;44:831-7. https://doi.org/10.1007/s00256-015-2111-y
  18. Patti JW, Ouellette H, Bredella MA, Torriani M. Impingement of lesser trochanter on ischium as a potential cause for hip pain. Skeletal Radiol. 2008;37:939-41. https://doi.org/10.1007/s00256-008-0551-3
  19. Xing Q, Feng X, Wan L, Cao H, Bai X, Wang S. MRI measurement assessment on ischiofemoral impingement syndrome. Hip Int. 2023;33:119-25. https://doi.org/10.1177/11207000211007750
  20. Hujazi I, Jones T, Johal S, Bearcroft P, Muniz-Terra G, Khanduja V. The normal ischiofemoral distance and its variations. J Hip Preserv Surg. 2016;3:197-202. https://doi.org/10.1093/jhps/hnw003
  21. Maras Ozdemir Z, Aydingoz u, Gormeli CA, Sagir Kahraman A. Ischiofemoral space on MRI in an asymptomatic population: normative width measurements and soft tissue signal variations. Eur Radiol. 2015;25:2246-53. https://doi.org/10.1007/s00330-015-3625-3
  22. Behrens SB, Deren ME, Matson A, Fadale PD, Monchik KO. Stress fractures of the pelvis and legs in athletes: a review. Sports Health. 2013;5:165-74. https://doi.org/10.1177/1941738112467423
  23. Kahanov L, Eberman LE, Games KE, Wasik M. Diagnosis, treatment, and rehabilitation of stress fractures in the lower extremity in runners. Open Access J Sports Med. 2015;6:87-95. https://doi.org/10.2147/OAJSM.S39512
  24. Aguilera-Bohorquez B, Pacheco J, Castillo L, Calvache D, Cantor E. Complications of hip endoscopy in the treatment of subgluteal space pathologies. Arthroscopy. 2021;37:2152-61. https://doi.org/10.1016/j.arthro.2021.02.016
  25. Gao Y, Liu X, Gu Y, et al. The effect of bisphosphonates on fracture healing time and changes in bone mass density: a meta-analysis. Front Endocrinol (Lausanne). 2021;12:688269. https://doi.org/10.3389/fendo.2021.688269
  26. Kates SL, Ackert-Bicknell CL. How do bisphosphonates affect fracture healing? Injury. 2016;47 Suppl 1:S65-8. https://doi.org/10.1016/S0020-1383(16)30015-8
  27. Barton DW, Smith CT, Piple AS, Moskal SA, Carmouche JJ. Timing of bisphosphonate initiation after fracture: what does the data really say? Geriatr Orthop Surg Rehabil. 2020;11:2151459320980369. https://doi.org/10.1177/2151459320980369
  28. Dutton RA. Stress fractures of the hip and pelvis. Clin Sports Med. 2021;40:363-74. https://doi.org/10.1016/j.csm.2020.11.007
  29. Shima Y, Engebretsen L, Iwasa J, Kitaoka K, Tomita K. Use of bisphosphonates for the treatment of stress fractures in athletes. Knee Surg Sports Traumatol Arthrosc. 2009;17:542-50. https://doi.org/10.1007/s00167-008-0673-0
  30. Robertson GA, Wood AM. Lower limb stress fractures in sport: optimising their management and outcome. World J Orthop. 2017;8:242-55. https://doi.org/10.5312/wjo.v8.i3.242