What is a bouncing hip

  A snapping hip is an audible or perceptible sound that occurs when the hip joint is actively extended and flexed and when walking. There are two types of rattling hips: intra-articular and peri-articular.  Intra-articular ringing hip is caused by congenital dislocation of the hip joint or relaxation of the joint capsule, resulting in ringing when the hip joint is over-extended and externally rotated. It should be treated regularly in the orthopedic department of the hospital.   Extra-articular snapping is more common. The main cause is the thickening of the posterior edge of the iliotibial bundle or the anterior edge of the gluteus maximus tendon. When the hip joint is flexed, internally retracted or internally rotated, the thickened tissue slides back and forth on the greater trochanter and emits a popping sound, while a thick and tight fibrous band can be seen and felt sliding over the greater trochanter. This phenomenon does not occur during passive motion, and is most often seen in young adults, often bilaterally. This popping often occurs spontaneously and can progress to the severity of one step. However, there is usually no pain, and if pain is present, it is often the result of a complication of bursitis in the greater trochanter.  The thickening of the anterior border of the iliotibial bundle or gluteus maximus tendon is associated with trauma or strain, which results in a series of pathological changes such as congestion and edema of the involved tissue and a sterile inflammatory response, leading to proliferation of fibrous tissue. Sometimes, the enlarged superior border of the greater trochanter hooks the posterior part of the iliotibial bundle and produces a popping sound; sometimes the popping sound is caused by the slippage of the iliopsoas tendon over the iliopubic node and/or the anterior inferior iliac spine; sometimes the popping sound is caused by the friction between the tense inferior border of the gluteus maximus and the sciatic bone during hip flexion; osteochondroma of the greater trochanter can also cause a popping hip. Patients with snapping hips often have internal rotation of the hip, and as the stem angle of the femoral neck becomes smaller, the force arms of the gluteus medius and gluteus minimus become shorter and the abduction function is affected, which increases the tension on the upper iliotibial bundle and causes snapping and dysfunction.  The diagnosis of a snapping hip is not difficult, as the patient is asked to extend and flex the hip on the affected side, and then to internally rotate it. However, it should be distinguished from intra-articular rattling. If the ringing hip is not accompanied by pain, treatment is usually not needed. If it is painful or if there is a mental burden for the ringing, rest, physiotherapy, braking and corticosteroids can be used to treat it. If the symptoms are heavy, the thickening of the striae is obvious, and conservative treatment is ineffective, surgery should be performed. Surgery is performed under local anesthesia, and there are four methods of surgery: (1) cutting or excision of the thickened cords until the popping and rubbing are completely eliminated, which is the commonly used procedure; (2) cutting of the cords and suturing of the distal end of the dislocation, if accompanied by bursitis and simultaneous removal of the greater trochanteric bursa; (3) lengthening of the iliotibial bundle, which can maintain the stability of the pelvis when standing or walking. ④If the local bony prominence is too large, the bony prominence can also be partially chiseled away, and early functional exercise after surgery.