Outcomes of Nonoperative Management, Iliopsoas Tenotomy, and Revision Arthroplasty for Iliopsoas Impingement after Total Hip Arthroplasty: A Systematic Review
Authors
Shapira J, Chen SL, Wojnowski NM, Lall AC, Rosinsky PJ, Maldonado DR, Domb BG
DOI: 10.1016/j.arth.2019.04.067
Background
Iliopsoas impingement (IPI) can occur after total hip arthroplasty (THA) and can be managed either conservatively, with iliopsoas tenotomy, or with revision surgery. This study reviews patient-reported outcomes (PROs) for these treatment methods.
Methods
Eleven articles with data on 280 hips were reviewed. The study compared PROs for nonoperative treatment, iliopsoas tenotomy, and acetabular component revision.
Key Findings
The tenotomy group had superior functional outcomes compared to the nonoperative group, with higher Harris Hip Scores and better results in several other outcome measures. Revision surgery showed improvements but had a higher complication rate.
Conclusions
Iliopsoas tenotomy is effective and has fewer complications than revision surgery for IPI after THA. It should be considered before opting for revision surgery.
What Does This Mean for Patients
If you're experiencing iliopsoas impingement after hip replacement, tenotomy may offer a safer and more effective solution than revision surgery.