Arthroscopic Peripheral Compartment Iliopsoas Release for Iliopsoas Impingement After Primary Total Hip Arthroplasty
Authors: Paraschos OA, Harris WT, Owens JS, Lall AC, Domb BG
Journal:Arthroscopy Techniques, January 2023
DOI:10.1016/j.eats.2022.08.066
Objective:
Describe a minimally invasive arthroscopic technique for iliopsoas tendon release in patients with iliopsoas impingement after total hip arthroplasty (THA).
Key Findings:
- Iliopsoas impingement post-THA causes persistent hip pain often related to cup malposition, leg length discrepancy, or spinal pathology.
- Arthroscopic iliopsoas release via the peripheral compartment, guided by fluoroscopy, offers a less invasive alternative to open surgery.
- This technique is especially valuable when conservative management fails.
Conclusion:
Arthroscopic iliopsoas release is an effective, minimally invasive option for addressing iliopsoas impingement after THA, reducing the need for more invasive open procedures.
What Does This Mean for Providers?
- Incorporate arthroscopic iliopsoas release into the treatment algorithm for persistent post-THA hip pain due to impingement.
- Use fluoroscopic guidance to safely navigate the peripheral compartment during the procedure.
- Consider this less invasive technique as a first surgical option before open release or revision THA.
- Thoroughly evaluate cup positioning and related factors preoperatively to identify suitable candidates.