Arthroscopic tendon release for iliopsoas impingement after primary total hip arthroplasty: a retrospective,
Enrico Tassinari1, Francesco Castagnini1,2, Federica Mariotti1
1Ortopedia-Traumatologia e Chirurgia Protesica e dei Reimpianti di Anca e Ginocchio, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
Introduction:
Aim of this study was to describe the clinical outcomes of 16 patients with iliopsoas (IP) impingement after primary total hip arthroplasty (THA), treated with an arthroscopic tendon release.
Methods:
16 patients (11 females/5 males), with a mean age of 57.8 ± 11.1 years (age at THA: 54.4 ± 11 years) and a diagnosis of IP impingement after primary THA, were treated with the Wettstein tenotomy. Preoperatively, every patient underwent a diagnostic ultrasonography guided peritendinous injection and a computed tomography (CT) scan. Every patient was clinically evaluated using WOMAC score. Subjective pain relief and active hip flexion strength were measured.
Results:
No complications related to arthroscopy were detected. Every cup was prominent with a mean axial overhang of 13 ± 4.8 mm (range 5-20 mm). At a mean follow-up of 27 ± 20.1 months (range 6-48 months), the WOMAC score was 83.7 ± 10.1 points. 13 patients out of 16 (81.3%) had a complete pain relief. 14 patients out of 16 (88%) regained full active hip flexion strength at the final follow-up. 1 patient was scheduled for cup revision after 6 months, due to persistent symptomatology. No demographic data or CT measurements about cup position statistically influenced the outcome.
Conclusions:
When preceded by an appropriate diagnosis, arthroscopic tenotomy proved safe and effective for IP impingement, regardless the magnitude of cup protrusion.
