Arthroscopic decompression of the iliopsoas tendon in patients with femoroacetabular impingement: medium-term clinical results

The iliopsoas tendon is a recognised cause of extra-articular pain in the hip, and tenotomy has been described as an effective treatment in patients who do not respond to conservative treatment. Endoscopic decompression has shown higher success rates, a lower rate of recurrence and fewer complications than open surgery. The purpose of this study was to report the results, at a mean of four years, of a series of patients who had femoroacetabular impingement in combination with iliopsoas tendinopathy, treated by hip arthroscopy and decompression of the tendon.
Fifteen patients were reviewed retrospectively. The radiological signs of femoroacetabular impingement were assessed, together with the alpha angle, the femoral head-neck offset and the centre-edge angle. Osteoarthritis was assessed on the anteroposterior radiograph according to the Tönnis classification. The patients were assessed using the Modified Harris Hip Score (mHHS), the VAIL score and the VAS score.
A statistically significant improvement in the functional scores was found. On the VAS score a statistically significant improvement was found from T0 to T2, from a median value of 5.5 to 0. Two patients reported recurrence of symptoms one year after the operation, and were treated conservatively. No other complications were reported.
Iliopsoas tendinopathy may be associated with femoroacetabular impingement in certain patients, and failure to diagnose and treat it may be the cause of poor results and of a revision operation. Arthroscopic decompression of the iliopsoas appears to produce good clinical results and to reduce pain and the rate of revision operations.
Source: “Muscles, Ligaments and Tendons Journal”, December 2016