Arthroscopic partial lengthening of the iliopsoas is a controversial technique. For many authors it is essential in cases of hip arthroscopy for femoroacetabular impingement and a tear of the acetabular labrum. For others it is an unnecessary and ineffective technique.
A recent article published in the journal “American Journal of Sports Medicine” investigated the hypothesis that patients undergoing arthroscopic surgery for femoroacetabular impingement and a tear of the acetabular labrum, with or without partial lengthening of the iliopsoas, would have similar results and that there would be no difference in the postoperative outcome at a minimum follow-up of two years.
The authors collected data retrospectively from 2009 to 2015. The patients eligible for the study underwent hip arthroscopy for femoroacetabular impingement and a tear of the acetabular labrum, with and without lengthening of the iliopsoas. Lengthening of the iliopsoas is indicated in cases of painful snapping hip. The minimum follow-up was two years. The hip assessment scales measured were the Harris Hip Score, International Hip Outcome Tool-12, Hip Outcome Score-Activity of Daily Living Score, Hip Outcome Score-Sports Specific Subscale and Non-Arthritic Hip Score, together with the visual analogue scale for pain, patient satisfaction, the minimal clinically important difference, and the proportion of patients in whom an acceptable symptom state was achieved. Repeat hip arthroscopies were also recorded, as well as subsequent total hip arthroplasties.
In total, 351 hips (307 patients) were recorded that met the criteria for the iliopsoas lengthening cohort. For the control group, 392 hips (354 patients) were recorded. Both groups showed significant postoperative improvement at the two-year review. The iliopsoas lengthening group showed results comparable with those of the control group.
This comparative cohort study showed that treatment of cases of painful internal snapping hip by arthroscopic lengthening of the iliopsoas is a safe technique with good immediate and medium-term results. The patients who underwent arthroscopic lengthening of the iliopsoas showed similar results, comparable with those of the control group, who were treated for femoroacetabular impingement of the acetabular labrum without lengthening of the iliopsoas.
The authors concluded that in carefully selected patients, arthroscopic partial lengthening of the iliopsoas does not have an adverse effect on the clinical outcome after hip arthroscopy.
Source: “American Journal of Sports Medicine”, September 2018
