Arthroscopic Iliopsoas Tenotomy After Total Hip Arthroplasty: Safe Method for the Right Patient

Overview

Journal J Exp Orthop

Publisher Wiley

Specialty Orthopedics

Date 2023 Jan 18

PMID 36652032

Authors

Sarantos Nikou

Ida Lindman

Arnar Sigurdsson

Louise Karlsson

Axel Ohlin

Eric Hamrin Senorski

Mikael Sansone

Affiliations

Soon will be listed here.

Abstract

Purpose: To evaluate the outcome of arthroscopic treatment for iliopsoas impingement after total hip arthroplasty (THA) 2 years after surgery using patient reported outcomes (PROM).

Methods: In this study 12 patients (13 hips) were included from a local hip arthroscopy registry. Patients completed web-based PROMs preoperatively and at a minimum of 2 years postoperatively. The PROMs included the International Hip Outcome Tool short version (iHOT-12), the Copenhagen Hip and Groin Outcome Score (HAGOS), the European Quality of Life-5 Dimensions Questionnaire (EQ-5D), the Hip Sports Activity Scale (HSAS) for physical activity level, the Visual Analog Scale (VAS) for overall hip function and a single question regarding overall satisfaction with the surgery.

Results: The mean age was 64.4 years (±15.1SD), mean body mass index (BMI) was 26.6 (±4.3SD), mean follow-up time was 49.8 months (±25SD). Comparing PROMs preoperatively with 2-year follow up showed an improvement for many of the PROMs used. The PROMs scores were iHOT-12 (24.9 vs 34.5, p = 0.13), HAGOS subscales (symptoms 38.2 vs 54.5, p = 0.05; pain 36 vs 53, p = 0.04; sport 14.1 vs 35.1, p = 0.03; daily activity 31 vs 47.5, p = 0.04; physical activity 21.8 vs 24, p = 0.76; quality of life 24 vs 35, p = 0.03), EQ-VAS (57.9 vs 58, p = 0.08), EQ-5D (0.34 vs 0.13, p = 0.07) and VAS for overall hip function (43.1 vs 46.2, p = 0.14). In total, 10 out of the 12 patients (83%) were satisfied with the intervention.

Conclusion: Patients undergoing surgery for iliopsoas impingement after previous THA showed improved self-reported hip function where most patients were satisfied with treatment.

Citing Articles

Arthroscopic and endoscopic techniques for iliopsoas release in THA are safe and effective: a systematic review of the literature.

Giai Via R, Giachino M, Elzeiny A, Donis A, De Vivo S, Bosco F Eur J Orthop Surg Traumatol. 2024; 34(6):2845-2857.

PMID: 38977435 PMC: 11377508. DOI: 10.1007/s00590-024-04042-1.

References

Lachiewicz P, Kauk J . Anterior iliopsoas impingement and tendinitis after total hip arthroplasty. J Am Acad Orthop Surg. 2009; 17(6):337-44. DOI: 10.5435/00124635-200906000-00002. View

Guicherd W, Bonin N, Gicquel T, Gedouin J, Flecher X, Wettstein M . Endoscopic or arthroscopic iliopsoas tenotomy for iliopsoas impingement following total hip replacement. A prospective multicenter 64-case series. Orthop Traumatol Surg Res. 2017; 103(8S):S207-S214. DOI: 10.1016/j.otsr.2017.09.007. View

Van Riet A, De Schepper J, Delport H . Arthroscopic psoas release for iliopsoas impingement after total hip replacement. Acta Orthop Belg. 2011; 77(1):41-6. View

OConnell R, Constantinescu D, Liechti D, Mitchell J, Vap A . A Systematic Review of Arthroscopic Versus Open Tenotomy of Iliopsoas Tendonitis After Total Hip Replacement. Arthroscopy. 2018; 34(4):1332-1339. DOI: 10.1016/j.arthro.2017.10.051. View

Chalmers B, Sculco P, Sierra R, Trousdale R, Berry D . Iliopsoas Impingement After Primary Total Hip Arthroplasty: Operative and Nonoperative Treatment Outcomes. J Bone Joint Surg Am. 2017; 99(7):557-564. DOI: 10.2106/JBJS.16.00244. View

Nunley R, Wilson J, Gilula L, Clohisy J, Barrack R, Maloney W . Iliopsoas bursa injections can be beneficial for pain after total hip arthroplasty. Clin Orthop Relat Res. 2009; 468(2):519-26. PMC: 2807015. DOI: 10.1007/s11999-009-1141-y. View

Shapira J, Chen S, Wojnowski N, Lall A, Rosinsky P, Maldonado D . Outcomes of Nonoperative Management, Iliopsoas Tenotomy, and Revision Arthroplasty for Iliopsoas Impingement after Total Hip Arthroplasty: A Systematic Review. J Arthroplasty. 2019; 34(9):2184-2191. DOI: 10.1016/j.arth.2019.04.067. View

Rabin R, de Charro F . EQ-5D: a measure of health status from the EuroQol Group. Ann Med. 2001; 33(5):337-43. DOI: 10.3109/07853890109002087. View

Jonasson P, Baranto A, Karlsson J, Sward L, Sansone M, Thomee C . A standardised outcome measure of pain, symptoms and physical function in patients with hip and groin disability due to femoro-acetabular impingement: cross-cultural adaptation and validation of the international Hip Outcome Tool (iHOT12) in Swedish. Knee Surg Sports Traumatol Arthrosc. 2013; 22(4):826-34. DOI: 10.1007/s00167-013-2710-x. View

10.

Dangin A, Tardy N, Wettstein M, May O, Bonin N . Microinstability of the hip: A review. Orthop Traumatol Surg Res. 2016; 102(8S):S301-S309. DOI: 10.1016/j.otsr.2016.09.002. View

11.

Moreta J, Cuellar A, Aguirre U, Casado-Verdugo O, Sanchez A, Cuellar R . Outside-in arthroscopic psoas release for anterior iliopsoas impingement after primary total hip arthroplasty. Hip Int. 2020; 31(5):649-655. DOI: 10.1177/1120700020909159. View

12.

Ekhtiari S, Haldane C, de Sa D, Simunovic N, Ayeni O . Fluid Extravasation in Hip Arthroscopy: A Systematic Review. Arthroscopy. 2017; 33(4):873-880. DOI: 10.1016/j.arthro.2016.11.009. View

13.

Thomee R, Jonasson P, Thorborg K, Sansone M, Ahlden M, Thomee C . Cross-cultural adaptation to Swedish and validation of the Copenhagen Hip and Groin Outcome Score (HAGOS) for pain, symptoms and physical function in patients with hip and groin disability due to femoro-acetabular impingement. Knee Surg Sports Traumatol Arthrosc. 2013; 22(4):835-42. DOI: 10.1007/s00167-013-2721-7. View

14.

Naal F, Miozzari H, Kelly B, Magennis E, Leunig M, Noetzli H . The Hip Sports Activity Scale (HSAS) for patients with femoroacetabular impingement. Hip Int. 2013; 23(2):204-11. DOI: 10.5301/hipint.5000006. View

15.

Prieto L, Novick D, Sacristan J, Edgell E, Alonso J . A Rasch model analysis to test the cross-cultural validity of the EuroQoL-5D in the Schizophrenia Outpatient Health Outcomes Study. Acta Psychiatr Scand Suppl. 2003; (416):24-9. DOI: 10.1034/j.1600-0447.107.s416.6.x. View

16.

Ueno T, Kabata T, Kajino Y, Ohmori T, Yoshitani J, Ueoka K . Tilt-adjusted Cup Anteversion in Patients with Severe Backward Pelvic Tilt is Associated with the Risk of Iliopsoas Impingement: A Three-dimensional Implantation Simulation. Clin Orthop Relat Res. 2019; 477(10):2243-2254. PMC: 6999943. DOI: 10.1097/CORR.0000000000000830. View

17.

Yalamanchili D, Shively S, Banffy M, Taliwal N, Clark E, Hunter G . Calculating Intraoperative Fluid Deficit to Prevent Abdominal Compartment Syndrome in Hip Arthroscopy. Arthrosc Tech. 2022; 11(1):e89-e93. PMC: 8807858. DOI: 10.1016/j.eats.2021.09.006. View

18.

Gedouin J, Huten D . Technique and results of endoscopic tenotomy in iliopsoas muscle tendinopathy secondary to total hip replacement: a series of 10 cases. Orthop Traumatol Surg Res. 2012; 98(4 Suppl):S19-25. DOI: 10.1016/j.otsr.2012.04.009. View

19.

Di Benedetto P, Niccoli G, Magnanelli S, Beltrame A, Gisonni R, Cainero V . Arthroscopic treatment of iliopsoas impingement syndrome after hip arthroplasty. Acta Biomed. 2019; 90(1-S):104-109. PMC: 6503398. DOI: 10.23750/abm.v90i1-S.8076. View

20.

Tassinari E, Castagnini F, Mariotti F, Biondi F, Montalti M, Bordini B . Arthroscopic tendon release for iliopsoas impingement after primary total hip arthroplasty: a retrospective, consecutive series. Hip Int. 2019; 31(1):125-132. DOI: 10.1177/1120700019893341. View