Endoscopic lesser trochanter resection for treatment of ischiofemoral impingement

Ischiofemoral impingement (IFI) is an uncommon source of hip pain characterized by abnormal proximity of the lesser trochanter (LT) and the anterior border of ischium. The condition can be treated non-operatively but in severe cases, LT excision can provide beneficial results. Most previous descriptions for IFI operation use an open surgical approach but with the advancement of arthroscopic surgery, the LT can be approached less invasively. This study describes a simple endoscopic method to decompress the LT. Due to the posteromedial location of LT, this method requires careful positioning of the leg, and the use of curved type instruments is recommended. Also, it is helpful to assess the amount of resection with a properly oriented fluoroscopic view.