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Results After Arthroscopic Treatment Of Iliopsoas Impingement After Total Hip Arthroplasty


Alexander Zimmerer, MD
GERMANY

Results After Arthroscopic Treatment Of Iliopsoas Impingement After Total Hip Arthroplasty

Wolfgang Miehlke, MD, GERMANY Christian Sobau, MD, GERMANY Alexander Zimmerer, MD, GERMANY

ARCUS Sportklinik, Pforzheim, GERMANY

2021 Congress   ePoster Presentation     Not yet rated

 

Anatomic Location

Hip / Groin / Thigh

Anatomic Structure

Tendon

Diagnosis / Condition

Impingement

Treatment / Technique

Arthroscopy

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Summary: Mechanical irritation and impingement of the iliopsoas tendon is an important diagnosis to be considered in persistent groin pain after total hip arthroplasty. In failure of non-operative treatment, good clinical results can be achieved with arthroscopic release and the pain level can be significantly reduced.

Background

A rare cause of groin pain after total hip arthroplasty is mechanical irritation or impingement of the iliopsoas tendon. The incidence is about 4%. If conservative therapy fails, an arthroscopic release of the iliopsoas tendon can be performed. The aim of the study was to assess the mid-term clinical outcome after arthroscopic release.

Methods

Using our in-house database, all patients who received an endoscopic release of the iliopsoas tendon due to mechanical irritation after total hip arthroplasty were identified. In these patients the modified Harris Hip Score, the pain level using the numerical analogue scale and the UCLA Activity Score were measured. The mean follow-up period was 6.75 years.

Results

25 patients were identified in whom an arthroscopic release of the iliopsoas tendon had been performed since 2007. The data of 20 patients were available at follow-up. The gender ratio was 1:1, the average age at the time of arthroscopy was 59 years. The average interval between THA and arthroscopy was 7 years.
The mHHS showed a significant improvement from preoperative 31.2 to 82 points (p = 0.001). The pain level on the NAS decreased significantly from 8.5 to 2.5 points (p = 0.001). The activity level based on the UCLA Activity Score raised from 4 to 6.5 (p = 0.09).

Conclusion

Mechanical irritation and impingement of the iliopsoas tendon is an important diagnosis to be considered in persistent groin pain after total hip arthroplasty. In failure of non-operative treatment, good clinical results can be achieved with arthroscopic release and the pain level can be significantly reduced.

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