APEX Hip Enhancing Clinical Expertise and Proficiency (November 2023)-Debate: Subspine is a Myth

Video Transcription

Video Summary

The speaker challenges the notion that Type II subspinous impingement is pathological, arguing it is often an anatomical variant not requiring surgical decompression. He reviews three AIIS types, noting Type I and II typically don’t cause symptoms or motion limitation, while only 3% (Type III) present with true pathology needing surgery. Risks of decompression include damaging the rectus femoris origin. Studies show no correlation between Type II morphology and impingement symptoms, suggesting surgery based on imaging alone is unjustified. Pathologic subspinous impingement exists but is rare and usually related to iatrogenic or traumatic causes, not normal anatomy.

Asset Caption

Travis G. Maak, M.D.

Keywords

Type II subspinous impingement

AIIS morphology

surgical decompression risks

rectus femoris origin damage

iatrogenic subspinous impingement