Indiscriminate Iliopsoas Tenotomy May Cause Complications-With Tight Indications and Transbursal Lengthening, We May Avoid Them

Indiscriminate Iliopsoas Tenotomy May Cause Complications-With Tight Indications and Transbursal Lengthening, We May Avoid Them

Authors

Domb BG, Maldonado DR
DOI: 10.1016/j.arthro.2021.04.065

Background

Iliopsoas tenotomy is used to treat painful internal snapping of the hip but can lead to complications like recurring pain, weakness, and snapping. The procedure may also be problematic in patients with hip instability, especially in those with hip dysplasia.

Methods

The commentary discusses the potential issues with iliopsoas tenotomy, and recommends a more controlled approach using iliopsoas fractional lengthening (IFL) instead. It emphasizes using this procedure only in specific cases where other stabilizing treatments can be applied.

Key Findings

Iliopsoas tenotomy can be effective but carries risks, especially in certain patients. IFL, a less invasive alternative, can treat snapping without damaging surrounding muscles or tissues, making it a safer option when combined with appropriate stabilization procedures.

Conclusions

The authors recommend using iliopsoas fractional lengthening in patients with internal snapping who also have a stable hip joint with adequate soft tissue support.

What Does This Mean for Patients

If you're experiencing painful snapping in the hip, and your doctor recommends surgery, consider asking about iliopsoas fractional lengthening, as it may offer a safer and more effective option compared to tenotomy.