Does Iliopsoas Lengthening Adversely Affect Clinical Outcomes After Hip Arthroscopy? A Multicenter Comparative Study

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Hip Arthroscopy

Background:

• Iliopsoas fractional lengthening (IFL) is a debated surgical technique in hip arthroscopy.
• Its efficacy in conjunction with femoroacetabular impingement (FAI) and labral tear treatment remains under investigation.

Purpose of the Study:

• To compare patient-reported outcomes (PROs) after arthroscopic surgery for FAI and labral tears with or without IFL.
• To evaluate the safety and effectiveness of IFL for painful internal snapping syndrome.

Main Methods:

• Retrospective review of 351 hips (IFL group) and 392 hips (control group) from July 2009 to April 2015.
• Minimum 2-year follow-up assessing multiple PROs, revision rates, and total hip arthroplasty (THA) conversion.
• IFL indicated for painful internal snapping syndrome.

Main Results:

• Both groups demonstrated significant postoperative improvement in PROs at 2-year follow-up.
• No significant differences were observed between the IFL and control groups in PRO improvement, minimal clinically important difference (MCID), patient acceptable symptomatic state (PASS), or revision/THA conversion rates.
• Mean follow-up was approximately 43 months for both cohorts.

Conclusions:

• Arthroscopic IFL is a safe procedure for treating painful internal snapping syndrome in patients with FAI and labral tears.
• IFL yields favorable short- to mid-term outcomes comparable to treatment without IFL in appropriately selected patients.
• The addition of IFL did not negatively impact clinical outcomes in this cohort study.