Arthroscopic treatment of iliopsoas cyst using outside-in technique-surgical technique and clinical outcomes

Due to the low prevalence of iliopsoas cysts, as well as the technical challenges involved in locating cysts from outside the joint capsule during arthroscopic surgery, there is a lack of comprehensive arthroscopy technique and clinical literature on this topic. We conducted a retrospective analysis and follow-up of five patients with iliopsoas cysts treated arthroscopically, over the past 3 years. Patient ages ranged from 39 to 73 years, with a mean age of 54 years. Our surgical approach involves the utilization of the outside-in technique to access and excise the cysts, along with potential concurrent procedures such as repair or debridement of the acetabular labrum. Each patient had a follow-up duration exceeding 23 months. The outcomes revealed significant pain relief and hip joint function improvement in all patients postoperatively. The Visual Analogue Scale scores reduced from a mean of 5.75 ± 0.43 preoperatively to 1.00 ± 0.70 postoperatively (P < .01), and the Modified Harris Hip Score increased from 50.75 ± 4.43 to 86.00 ± 4.47 (P < .01). For individuals presenting with symptoms of groin pain in the presence of a radiologically confirmed iliopsoas cyst, hip arthroscopy using the outside-in technique represents a minimally invasive and reliable approach for cyst removal.