The role of arthroscopy in treating pain after total hip arthroplasty: our experience

This very interesting article, published in May 2016 in the journal Hip International, presented the arthroscopic technique and its results in patients with chronic pain after total hip arthroplasty.
Between 2009 and 2011, 35 patients with persistent pain after total hip arthroplasty were treated arthroscopically. These patients underwent a preoperative assessment consisting of a careful history, physical examination, laboratory investigations and imaging with radiographs and CT scans. In patients whose clinical picture suggested iliopsoas tendinitis, an injection of local anaesthetic was given into the tendon sheath. All the patients were operated on in the supine position on a traction table, using two arthroscopic portals. An extensive debridement of the adhesions, the periprosthetic tissue and the neocapsule was carried out. Where there were signs of iliopsoas impingement, a trans-capsular tenotomy was performed according to the Wettstein technique.
The mean age of the patients was 57 years and the mean time to onset of symptoms was 10.8 months after the total hip arthroplasty. The mean preoperative Harris Hip Score was 44.1. After 24 months of follow-up the patients showed a mean score of 75.73. The patients who underwent release of the iliopsoas tendon showed a postoperative score of 83.28.
The authors concluded that hip arthroscopy in the treatment of reactive synovitis and adhesions shows good results in the literature. In the treatment of anterior iliopsoas impingement, hip arthroscopy is the most useful tool in patients with a painful total hip arthroplasty, since it is far less invasive than the classic open technique.
Source: “Hip International”, 2016