Arthroscopic Psoas Tenotomy

Case Report: Bifid Iliopsoas Tendon Causing Refractory Internal Snapping Hip

“…Arthroscopic iliopsoas tendon release was performed from lateral to medial using electrocautery, taking care to avoid the anterior femoral neurovascular bundle. A complete release was confirmed by observation of the iliacus muscle fibers and noting the 10-mm retraction of the cut tendon ends [21].…”

“…Treatment of painful internal snapping hip via arthroscopic release is becoming preferred over open techniques because of the benefits of minimal dissection, the ability to address concomitant intraarticular disorders, and a low complication rate [5,8,9,12]. Numerous authors have reported excellent results with arthroscopic iliopsoas tenotomy at 1 to 2 years postoperatively, with no refractory cases of snapping, minimal to no weakness, and a high prevalence of associated intraarticular disorders that can be managed arthroscopically at the same time [2,3,10,11,21].…”

“…The tendon was approached through a 15-mm capsulotomy just proximal to the zona orbicularis and lateral to the medial synovial fold, again using the technique of Wettstein et al [21]. This location was the same as that in her index capsulotomy, although larger, and it allowed more extensive observation of the tendon.…”

Hip arthroscopy for extra-articular hip disease

“…Two techniques of hip endoscopy have been described for treating internal snapping hip [35,50]. The iliopsoas tendon can be released either at its insertion into the lesser trochanter or via a transcapsular technique at the level of the hip joint [35,49,50].…”

“…The iliopsoas tendon can be released either at its insertion into the lesser trochanter or via a transcapsular technique at the level of the hip joint [35,49,50]. These procedures can be successfully done either from the lateral decubitus position [42,49] or from the supine position [35,44,[51][52][53].…”