Arthroscopic iliopsoas release results in iliopsoas atrophy with a 25% volume loss and a 19% reduction in seated hip flexion strength.

lesser trochanter versus those who underwent iliopsoas release from the peripheral compartment, found equally favorable Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores at final follow-up.These studies and others suggest that given the correct indication (ie, painful internal snapping), iliopsoas release is both safe and effective, either in isolation or as part of the comprehensive management of intra-articular abnormalities. We commend the authors for bringing up strength loss and atrophy as important areas for future study. Furthermore, the authors employed an elegant imaging methodology to measure the volume of the iliopsoas and a useful strength measurement apparatus, both of which may prove useful in future studies. The current study is limited by a low percentage of follow-up and significant potential for selection bias and response bias. Because of these limitations, no conclusions can or should be made regarding efficacy, clinical outcomes, or adverse effects. Future studies that include a rigorous study design, consecutive matched or randomized cohorts, and a high rate of clinical followup may enable us to better assess the usefulness, and the risks, of iliopsoas lengthening.