2021 ISAKOS Biennial Congress ePoster
Arthroscopic Tendon Release for Iliopsoas Impingement after Total Hip Arthroplasty
Michael Andreas Finsterwald, MD, Bull Creek, WA AUSTRALIA
Georgina Waters, MD, Perth AUSTRALIA
Jay R. Ebert, PhD, Perth, WA AUSTRALIA
Christopher W. Jones, FAOrthA FRACS PhD MBBS(Hons) BEng(Hons) BCom, East Fremantle, WA AUSTRALIA
Piers Yates, MBBS(Hons) BSc(Hons) MRCS(Eng) FRCS(Tr & Orth) FRA, Perth AUSTRALIA
Peter Alberto D'Alessandro, MBBS Hons. (UWA) FRACS FAOrthA, Claremont, WA AUSTRALIA
Orthopaedic Research Foundation of Western Australia (ORFWA), Perth, AUSTRALIA
FDA Status Not Applicable
Summary
Arthroscopic Tendon Release for Iliopsoas Impingement after Total Hip Arthroplasty yields in high success rates and satisfaction with a negligible complication profile.
ePosters will be available shortly before Congress
Abstract
Introduction
This prospective study investigated clinical and functional outcomes after arthroscopic iliopsoas tendon release at the level of the lesser trochanter (LT) for iliopsoas impingement (IPI) after primary, revision or resurfacing total hip arthroplasty (THA).
Methods
We analysed a consecutive series of patients with groin pain after THA, subsequently diagnosed with IPI and treated with arthroscopic iliopsoas tendon release between November 2017 and January 2021. Clinical assessment included examination for iliopsoas provocation, positive response to diagnostic injection and functional imaging to assess cup position and contact pattern. Outcome measures included visual analogue pain score (VAS), hip function, health status, surgical time and complications. Post operative hip flexion strength was assessed by dynamometer.
Results
34 consecutive patients (10 male, 24 female) with a mean age of 62 (range 27-83) were included. 27 patients had a primary THA in situ, 3 a hip resurfacing and 4 a revised cup. All procedures were performed arthroscopically by a fellowship trained hip arthroscopist. At last follow-up (mean 7.2 months) 91% of patients had significantly reduced pain, on average from VAS 6 to 1.2. Perceived hip function (SANEhip) and modified Harris Hip Score (M-HHS) significantly improved from preoperative scores of 48 and 59 respectively to 76 and 84 (p<0.05). Similarly, physical and mental health status (VR-12) improved significantly. Seated peak isometric flexion strength at minimum 6 months was insignificantly lower compared to the nonoperative side. Mean surgical time was 24 minutes (range 15-30), and no complications were reported.
Conclusion
Arthroscopic iliopsoas tendon release for patients with IPI after THA provides significant pain relief and greatly improves hip function with a negligible complication profile. It is a useful diagnostic consideration and treatment option for patients with groin pain following total hip arthroplasty.