Midterm Outcomes of Iliopsoas Fractional Lengthening for Internal Snapping as Part of Hip Arthroscopy for Femoroacetabular Impingement and Labral Tear: A Matched Control Study

Midterm Outcomes of Iliopsoas Fractional Lengthening for Internal Snapping as Part of Hip Arthroscopy for Femoroacetabular Impingement and Labral Tear: A Matched Control Study

Authors: Perets I, Chaharbakhshi EO, Mansor Y, Ashberg LJ, Mu BH, Battaglia MR, Lall AC, Domb BG

DOI: 10.1016/j.arthro.2018.11.050

Background:

• Internal snapping hip caused by iliopsoas tendon irritation is common in patients with FAI or labral pathology.
• Iliopsoas fractional lengthening (IFL) may relieve symptoms when performed alongside hip arthroscopy.

Methods:

• 57 patients with snapping hip underwent IFL during arthroscopy and were compared with a matched group (FAI and labral tears only).
• Follow-up: Minimum of 5 years.

Key Findings:

• 80% resolution of internal snapping in the IFL group.
• Significant improvements in pain and function comparable to controls.
• No significant increase in complications or revision rates.

What Does This Mean for Providers?

• IFL is an effective adjunct to hip arthroscopy for patients with internal snapping and coexisting intra-articular pathology.
• Incorporating IFL may improve patient comfort and satisfaction without increasing surgical risk.
• Proper diagnosis and patient selection are crucial; persistent painful snapping should not be overlooked in the presence of labral or FAI pathology.
• Midterm data support safety and efficacy, but long-term durability should continue to be monitored.