Arthroscopic and Endoscopic Management of the Internal Snapping Hip Syndrome

Internal snapping hip syndrome or coxa saltans interna results from the iliopsoas tendon snapping over the superior pubic ramus, iliopectineal eminence, anterior hip joint, femoral head or the lesser trochanter. This condition occurs in either the native hip or a prosthetic hip joint. Conservative management is the mainstay treatment, but iliopsoas release continues to be the definitive treatment in patients with failed conservative measures. The arthroscopic iliopsoas release from the central or peripheral compartment is useful in the management of internal snapping syndrome and may have less hip flexion strength deficits postoperatively as compared to the releasing from the lesser trochanteric level. Endoscopic iliopsoas release at the lesser trochanter level is the preferred operative treatment option for internal snapping patients who have undergone a total hip replacement.