How has Arthroscopic Management of the Iliopsoas Evolved, and Why? A Survey of High-Volume Arthroscopic Hip Surgeons
Authors
Chen AW, Steffes MJ, Laseter JR, Maldonado DR, Ortiz-Declet V, Perets I, Domb BG
DOI: 10.1093/jhps/hnaa023
Background
The iliopsoas tendon can cause internal snapping in the hip, and arthroscopic treatments like tenotomy (cutting the tendon) are used, but the best approach remains unclear.
Methods
A survey was conducted among 16 high-volume hip surgeons to understand how they manage the iliopsoas tendon during hip arthroscopy and why certain techniques are chosen.
Key Findings
- Most surgeons perform iliopsoas tenotomy for recalcitrant internal snapping and often do so alongside labral repair.
- Over time, surgeons have reduced the frequency of tenotomy, mainly due to concerns about hip flexion weakness post-surgery.
- Surgeons are less likely to perform tenotomy in patients with borderline dysplasia or ligamentous laxity.
Conclusions
The approach to iliopsoas treatment during hip arthroscopy has evolved, with decreasing use of tenotomy due to concerns about potential weakness, especially in certain patients.
What Does This Mean for Patients
If you are undergoing hip arthroscopy for iliopsoas-related issues, the treatment may involve a tendon release, but if you have specific conditions like borderline dysplasia, your surgeon may opt for alternative techniques to avoid complications.