Fascia Lata Release

Dean Papaliodis, M.D. Orthopaedic Surgeon, Sports Medicine Specialist, Fort Worth, Keller, TX / Services / General Orthopedics / Procedures / Fascia Lata Release

What is a Fascia Lata Release?

Fascia lata release is a surgical procedure employed for the treatment of individuals with resistant extra-articular Snapping Hip (Coxa Saltans) Syndrome who have failed to recover with conservative treatment. During this procedure, tight and stiffened fascia lata muscles or the iliotibial band in the thigh or hip region is surgically released to alleviate chronic or severe groin pain and improve range of motion.

The fascia refers to the sheet or band of fibrous tissue lying deep in the skin. The fascia lata is the deep fascia of the thigh and covers the adductor muscles of the medial thigh and constitutes the outer limit of the fascial compartments of the thigh. The fascia lata starts proximally around the inguinal ligament and iliac crest and ends distal to the bony prominences of the tibia. The fascia lata is thickened at its lateral side where it forms the iliotibial tract or iliotibial (IT) band, a structure that runs to the tibia and serves as a site of muscle attachment.

Adductor muscles are a group of 5 powerful muscles located in the medial compartment of the thigh that are collectively referred to as hip adductors. Their main function is to bring the thigh and hip towards the body (adduction).

Coxa Saltans is characterized by a painful clunk or clicking sound that occurs often during specific movements of the lower limb. It is caused by a tightness of the iliotibial band along the lateral thigh causing it to snap forward and back across the bony prominence of the greater trochanter (hip region) with movement. The tightness of the IT band is thought to be a result of repetitive injury to the undersurface of the muscle which becomes progressively thickened, intensifying the symptoms. It is one of the most common causes of medial leg and groin pain, especially among athletes who are involved in football, rugby, soccer, hockey, basketball, and running that involves swift changes in speed and direction, kicking, twisting and turning, etc.

Indications for a Fascia Lata Release

Snapping hip syndrome is the main indication for a fascia lata release. Some of the other indications include:

Osteitis pubis
Sportsmen's groin, also called sports hernia and Gilmore groin
Adductor strain, also known as groin pull or groin strain
Overuse stress fractures
Inguinal hernia

Preparation for a Fascial Lata Release

Preoperative preparation for a fascia lata release includes:

A thorough examination is performed by your doctor to check for any medical issues that need to be addressed prior to surgery.
Test such as the Ober’s test which may detect a tight iliotibial band and imaging tests may be ordered to detect any abnormality around the site of injury.
Make sure to inform your doctor if you have any allergies to medications or anesthesia.
You should inform your doctor of any medications, vitamins, or supplements that you may be taking.
You should refrain from medications or supplements such as blood thinners, NSAIDs, or vitamin E for several days prior to surgery.
You should not consume any solids or liquids at least 8 hours prior to surgery.
You should refrain from smoking as tobacco affects blood circulation and increases the risk of complications.
Arrange for someone to drive you home as you will not be able to drive yourself post surgery.
A written consent will be obtained from you after the surgical process has been explained in detail.

Procedure for a Fascia Lata Release

The procedure is mostly performed as a same-day surgery, although a short overnight stay may be needed. The procedure involves the following steps:

Local or general anesthesia is administered prior to beginning the surgery.
Your surgeon makes a 5 cm incision just below the prominence at the side of your hip (greater trochanter) to gain access to the fascia lata.
A cruciate-type incision is utilized to release the tight bands of the fascia lata crossing and overlying the trochanter.
The surrounding soft tissue structures are also evaluated for any pathology and repaired accordingly.
Local anaesthetic infiltration is utilised to alleviate post-operative discomfort.
The incisions are closed in layers and a sterile dressing is applied.

Postoperative Care and Instructions for a Fascia Lata Release

The general postoperative care and instructions involve:

You will be transferred to the recovery area to be monitored until you are awake from the anesthesia.
Your nurse will monitor your blood oxygen level and other vital signs as you recover.
You will be encouraged to get up and walk as frequently as possible to prevent blood clot formation.
You can expect pain and soreness in the groin area. Pain medications will be prescribed for comfort.
Refrain from any strenuous activities and do not lift any heavyweights. You should gradually increase your activity level with light activities.
Physical therapy and an exercise regimen will be gradually started to enhance range of motion and help strengthen core muscles.
Instructions on surgical site care, driving, and bathing will be provided.
Refrain from smoking as it can negatively affect the healing process.
You may return to normal activities in a couple of weeks but return to sport will depend on the extent of muscle injury and may require 6 to 12 weeks or longer.
Strictly adhere to scheduled follow-up appointments to monitor your progress.

Risks and Complications of Fascia Lata Release

Fascia lata release is a relatively safe procedure; however, as with any surgery, there may be some minor risks and complications associated with fascia lata release, such as: