Surgical Management Results in Lasting Pain Relief in Patients with Ischiofemoral Impingement Refractory to Nonoperative Treatment: A Systematic Review.

purpose of reviewThis study aims to systematically review the current literature on treatment strategies for ischiofemoral impingement (IFI), focusing on the outcomes of nonoperative, arthroscopic, and open surgical interventions. RECENT

findingsIFI is an uncommon but increasingly recognized cause of posterior hip and deep gluteal pain, resulting from narrowing of the space between the ischial tuberosity and the lesser trochanter. Seven studies (level IV evidence) encompassing 101 patients (107 hips) were identified. Majority of patients were female (91%) with mean ages 26-47 years and follow-up ranging 18-48 months. Image-guided quadratus femoris injections provided short-term pain relief but limited long-term benefit. Arthroscopic lesser trochanter (LT) resection demonstrated consistent improvement in hip function and return to activity, with minimal complications and revision rates. One study on open derotation osteotomy reported significant improvements in range of motion, reduced impingement symptoms, and high patient satisfaction. Both conservative and surgical treatments improve symptoms of IFI, though surgical decompression reports sustained benefit. Arthroscopic LT resection shows promise as a safe and effective intervention. However, current evidence is limited to small, retrospective series without direct comparisons. Future prospective, comparative studies using standardized outcome measures are needed to define optimal management strategies for IFI.