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. Materials and 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.

Background/Objectives: Pigmented villonodular synovitis (PVNS) is a benign proliferation of synovial tissue that can cause joint damage. The hip, although less commonly affected than the knee, presents a challenging diagnosis and treatment, with magnetic resonance imaging (MRI) as the gold standard for detection. Surgical excision, arthroscopic or open, is the main treatment approach, but there is no consensus on the best strategy for the hip. The aim of this systematic review is to evaluate the clinical outcomes, complications, and revision rates associated with arthroscopic hip surgery for PVNS. Methods: A systematic review was performed following the PRISMA guidelines. Relevant studies were identified by searching four databases: PubMed, Scopus, Embase, and Medline. Selected articles were evaluated according to the criteria of levels of evidence (LoE). For retrospective studies, the Coleman Methodology Score (mCMS) was used. This systematic review was registered with the International Prospective Register of Systematic Reviews. Results: Six studies satisfied the criteria; these involved 77 patients (48% male, 52% female) with a mean age of 26.4 years and a mean follow-up of 54.3 months. MRI and biopsy confirmed the diagnoses, and arthroscopic synovectomy was the primary treatment. Success rates ranged from 80% to 100%, with a recurrence rate of 7.8%, 1.3% requiring revision surgery, and eight (10.4%) patients in three studies reporting conversion to THA. Complications included mild effusions and residual synovitis. All patients who underwent a subsequent total hip arthroplasty were affected by advanced osteoarthritis. Conclusions: Our systematic review reveals that the use of hip arthroscopy in diagnosing and treating PVNS has shown satisfactory results without increasing the risk of recurrence or complications and can return patients to their former activity levels, provided their preoperative osteochondral status is good and there is early management of PVNS of the hip joint.

Sacroiliac joint (SIJ) dislocations, particularly pure SIJ dislocations without associated fractures, represent a rare and complex subset of pelvic ring injuries. Given the intricate pelvic anatomy and the need to achieve both stability and functional recovery, the optimal surgical management for these injuries remains a topic of debate. This systematic review aims to evaluate the various surgical techniques employed in treating this rare and challenging injury and assess associated clinical outcomes and complications. 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 included studies were analyzed using the Methodological index for non-randomized studies (MINORS) criteria for quality assessment. This paper was registered in the International Prospective Registry of Systematic Reviews (PROSPERO). The review identified four studies. The surgical techniques varied across studies, with percutaneous fixation, open reduction and internal fixation (ORIF), and combined approaches being the most reported methods. Clinical outcomes generally indicated satisfactory pain relief and functional recovery (Majeed score 57-90), though the rates of complications, including hardware failure (4-17 %) and infection (17-32 %), were notable. The results also highlighted that anatomical reduction and stable fixation are crucial for optimizing outcomes and minimizing complications. However, the heterogeneity of the data, especially the timing of surgery and surgical technique, precluded a formal meta-analysis. Surgical management of pure SIJ dislocations presents significant challenges due to the complex biomechanics of the pelvic ring. While various surgical techniques have been employed with generally positive outcomes, the lack of high-quality, large-scale studies limits the ability to establish definitive guidelines. Early definitive treatment of these injuries and anatomical reduction of the SIJ are the main factors to improve clinical outcomes and reduce complication rates. IV.