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Arthroscopic Tendon Release for Iliopsoas Impingement after Total Hip Arthroplasty

Michael Andreas Finsterwald, MD
AUSTRALIA

Arthroscopic Tendon Release for Iliopsoas Impingement after Total Hip Arthroplasty

Michael Andreas Finsterwald, MD, AUSTRALIA Georgina Waters, MD, AUSTRALIA Jay R. Ebert, PhD, AUSTRALIA Christopher W. Jones, FAOrthA FRACS PhD MBBS(Hons) BEng(Hons) BCom, AUSTRALIA Piers Yates, MBBS(Hons) BSc(Hons) MRCS(Eng) FRCS(Tr & Orth) FRA, AUSTRALIA Peter Alberto D'Alessandro, MBBS Hons. (UWA) FRACS FAOrthA, AUSTRALIA

Orthopaedic Research Foundation of Western Australia (ORFWA), Perth, AUSTRALIA

2021 Congress ePoster Presentation Not yet rated

Anatomic Location

Hip / Groin / Thigh

Anatomic Structure

Tendon

Diagnosis / Condition

Impingement

Treatment / Technique

Endoscopy

Diagnosis Method

Physical Examination X-ray CT-Scan

Sports Medicine

Outcome Studies

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Summary: Arthroscopic Tendon Release for Iliopsoas Impingement after Total Hip Arthroplasty yields in high success rates and satisfaction with a negligible complication profile.

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.

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Outcomes Of Revision Hip Arthroscopy Are Unaffected By Intraoperative Findings: A Matched Cohort Study ePoster Presentation Hari Krishna Ankem, MD, UNITED STATES Samantha Diulus, BS, UNITED STATES Cynthia Kyin, BA, UNITED STATES Jacob Shapira, MD, UNITED STATES Philip Joseph Rosinsky, MD, UNITED STATES Mitchell Meghpara, MD, UNITED STATES Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
Outcomes of Associated Both Column Acetabular Fractures with and without a Posterior Wall Fracture ePoster Presentation George Bradley Reahl, MS, UNITED STATES Michael McTague, MPH, UNITED STATES Nishant Suneja, MD, UNITED STATES Arvind Von Keudell, MD, UNITED STATES
A Prospective Comparison Of Groin-Related Complications Following Hip Arthroscopy With Versus Without A Perineal Post ePoster Presentation Iciar M Davila Castrodad, MD, UNITED STATES Matthew J. Kraeutler, MD, UNITED STATES Omer Mei-Dan, MD, UNITED STATES Anthony Scillia, UNITED STATES
Endoscopic Iliopsoas Lengthening For Treatment Of Recalcitrant Iliopsoas Tendinitis After Total Hip Arthroplasty Abstract Presentation 5 minutes Marc R. Safran, MD, Prof., UNITED STATES John Carlo Bonano, MD, UNITED STATES Christopher Jamero, MA, ATC, UNITED STATES Nicole Alexandria Segovia, BA, UNITED STATES James I. Huddleston, MD, UNITED STATES
Cannabis Use Is Not Associated With Increased Opioid Use Or Costs After Hip Arthroscopy Abstract Presentation 5 minutes Christopher L. McCrum, MD, UNITED STATES Jacob Thomas Wood, BS, UNITED STATES Senthil Sambandam, MD, UNITED STATES
Predicting Dissatisfaction Following Total Hip Arthroplasty Using A Bayesian Model Averaging (Bma) Approach: Results From The Australian Arthroplasty Clinical Outcomes Registry (Acorn) ePoster Presentation Jan Peter Van Meirhaeghe, MD, BELGIUM Rob Molnar, MBBS, AUSTRALIA Sam Adie, BSc(Med) MBBS MSpMed MPH PhD FRACS, AUSTRALIA
Utilizing Laser Doppler Flowmetry To Measure Labral Blood Flow During Arthroscopic Acetabular Labral Repair Abstract Presentation 5 minutes Paul F Abraham, BS, UNITED STATES Mark R. Nazal, MPH, UNITED STATES Nathan Varady, MD, MBA, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Christopher T Eberlin, BS, UNITED STATES Stephen M Gillinov, AB, UNITED STATES Wendy Madeline Meek, BBA, UNITED STATES Scott D Martin, MD, UNITED STATES
Solving Social Inequality In Surgical Outcomes By Combining Standardized Treatment And Individualized Patient Education ePoster Presentation Benjamin Saks, MD, UNITED STATES Vivian Ouyang, BS, UNITED STATES Andrew Jimenez, MD, UNITED STATES Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
Evaluation of endoscopically gluteus medius repair in patients with Femoro-acetabular impingement and labrum detachment ePoster Presentation George D. Tsikouris, MD, GREECE Nikolaos D. Gravvanis, MD, GREECE Georgia S. Dedousi, MD, GREECE Panagiota Vlaserou, BSc in Physiotherapy, MSc Biomedical Engineer, GREECE Fanis P. Papadakis, BSc, MSc(cand.), GREECE Ioannis K. Antonopoulos, GREECE Vassilis N. Psychoyios, MD, GREECE Theodoros G. Troupis, Prof, GREECE
Natural History Of Femoroacetabular Impingement: Using Machine Learning To Evaluate Risk Factors For Osteoarthritis In A Large Geographic Population Over The Long-Term Abstract Presentation 5 minutes Ayoosh Pareek, MD, UNITED STATES Sunho Ko, MD, KOREA, NORTH Heath Melugin, MD, UNITED STATES Changwung Jo, MD, KOREA, REPUBLIC OF Ryan R Wilbur, BS, UNITED STATES Bryant M. Song, MS, UNITED STATES Aaron J. Krych, MD, UNITED STATES
Promis Mobility: Evaluation Of The Lower Extremity-Specific Instrument In A Sports Medicine Hip Registry ePoster Presentation Molly A Day, MD, UNITED STATES Ryan S. Selley, MD, UNITED STATES Kyle Hancock, MD, UNITED STATES Reena Olsen, BS, UNITED STATES Danyal H. Nawabi, MD, FRCS(Orth), UNITED STATES Benedict U. Nwachukwu, MD, MBA, UNITED STATES Stephanie S Buza, MD, UNITED STATES Anil S. Ranawat, MD, UNITED STATES Bryan T. Kelly, MD, UNITED STATES
Efficacy Of Tranexamic Acid In Hip Fracture Surgeries ePoster Presentation Aabid Sanaullah, MBBS,MRCS,MRCPS,PGDipTrauma Surg.FEBOT,FRCSTr&Orth, UNITED KINGDOM Adeel Nawab Ditta, MBBS, MRCS, UNITED KINGDOM Olufunso Damilare Onayemi, MRCS MCH (Ortho), UNITED KINGDOM Ahsan Sheeraz, BSc MBBS MRCS, UNITED KINGDOM Atif A. Malik, MB ChB, MRCS Ed, MSc. (Orto. Eng), FRCS Tr & Orth, UNITED KINGDOM
Mid-Term Outcome and Strength Assessment after Proximal Rectus-Femoris-Refixation in Athletes ePoster Presentation Maximilian Hinz, MD, GERMANY Stephanie Geyer, MD, GERMANY Felix Winden, Cand Med, GERMANY Alexander Braunsperger, B.Sc., GERMANY Florian Kreuzpointner, PhD, GERMANY Benjamin Daniel Kleim, MBBS, MD, MRes, GERMANY Andreas B. Imhoff, MD, Prof. Emeritus, GERMANY Julian Mehl, MD, GERMANY
Treatment Modalities And Outcomes Following Acetabular Fractures In The Elderly: A Systematic Review Abstract Presentation 3 minutes Brian McCormick, MD, UNITED STATES Joseph Serino, MD, UNITED STATES Sebastian Orman, MD, UNITED STATES Alex R. Webb, MD, UNITED STATES David X. Wang, MD, UNITED STATES Sharri Mortenson, MD, UNITED STATES Arvind Von Keudell, MD, UNITED STATES

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Arthroscopic Tendon Release for Iliopsoas Impingement after Total Hip Arthroplasty

Arthroscopic Tendon Release for Iliopsoas Impingement after Total Hip Arthroplasty

Introduction

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Conclusion

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Arthroscopic Tendon Release for Iliopsoas Impingement after Total Hip Arthroplasty

Arthroscopic Tendon Release for Iliopsoas Impingement after Total Hip Arthroplasty

Introduction

Methods

Results

Conclusion

More ISAKOS 2021: Global Content