Anatomically, the iliopsoas, a deep muscle group, joins the spine to the lower limbs.
Background:
Up to 4.3 percent of patients who have total hip arthroplasty (THA) experience functional groin pain due to iliopsoas impingement. Historically, surgical treatments have included acetabulum revision or open iliopsoas tenotomies. In order to assess the effectiveness and hazards of endoscopic iliopsoas tenotomy for iliopsoas impingement following THA, we provide a sizable single surgeon series of patient cases.
Methods:
The endoscopic iliopsoas tenotomy performed on a sequential series of 60 patients with iliopsoas impingement following THA was retrospectively assessed. Complications, changes in Hip Outcome Score (HOS), and pain relief were all evaluated as outcomes. A musculoskeletal radiologist examined the radiographs to assess component placement and to contrast with a control cohort.
Results:
93.3 percent of patients reported pain relief at the most recent follow-up (mean 5.5 months). The mean of the HOS activities of daily living (ADL) subscale was 57.5 before surgery (range: 10.9-89.3, SD: 18.8), and it was 71.6 after surgery (range: 14.1-100, SD: 26.1) (P =.005). Preoperatively, the HOS sports subscale had a mean of 37.3 (range 0-83.3, SD 24.0), and postoperatively, it had a mean of 58.1 (range 0-100, SD 33.2) (P =.002). A postoperative hematoma that was treated conservatively was the only documented consequence. Iliopsoas symptoms following THA in this series were linked to body mass index and greater offset.
Conclusion:
Endoscopic iliopsoas tenotomy following THA had a low rate of complications, a 93.3 percent pain remission rate, and clinically significant improvements in HOS. Patients who have iliopsoas impingement after THA should be treated with endoscopic tenotomy.
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