Arthroscopic tendon release for iliopsoas impingement after primary total hip arthroplasty: a retrospective, consecutive series

Tassinari, Enrico; Castagnini, Francesco; Mariotti, Federica; Biondi, Federico; Montalti, Maurizio; Bordini, Barbara; Traina, Francesco

doi:10.1177/1120700019893341

Cited by 16 publications

(16 citation statements)

References 20 publications

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“…The most notable clinical concern about ceramic large heads is the risk of soft-tissue impingement and consequent groin pain, mainly due to the mechanical irritation of the iliopsoas tendon/capsule [18]. Only Lavigne et al [15] reported a discrete rate of mild and moderate groin pain (7.1%), which significantly impacted the clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

Ceramic-on-Ceramic Total Hip Arthroplasty with Large Diameter Heads: A Systematic Review

et al. 2020

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Ceramic-on-ceramic (COC) total hip arthroplasties (THAs) with large heads (>36 mm) were introduced to reduce dislocation rates and restore the hip anatomy as closely as possible to the native one. To date, the literature is scarce and fragmented; a review is desirable to point out the outcomes and the possible specific complications (noise, groin pain, and taperosis). A systematic review about large-diameter COC THAs was conducted according to the PRISMA guidelines. The PubMed and Cochrane databases were searched using the terms “large”, “big”, “head”, “hip”, and “ceramic.” The methodological quality of the papers was assessed using the MINORS (Methodological Index for Nonrandomized Studies) score. Seven papers (level of evidence: 5 case series and 2 case-control studies) met the inclusion criteria. Clinical outcomes were excellent in >90% of the patients. Groin pain was reported in only 1 article (7%). Radiological outcomes were positive. Minimal revision rates (<2%) were reported at short- to mid-term follow-ups. Dislocation rates were usually <1%. No bearing surfaces failed. No case of trunnionitis was reported. Noise occurred in up to 30% of the patients, mostly squeaking. The noise did not influence clinical outcomes or patients’ satisfaction. Noise was inconstantly associated with component positioning, younger age, high articular excursions, and larger sizes. Large-diameter heads in COC THAs (≥40 mm) showed promising clinical and radiological outcomes with minimal revision rates. Noise is a cause of concern and should be carefully evaluated at longer follow-ups and in larger, prospective, and specifically designed case series.

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Section: Discussionmentioning

confidence: 99%

Ceramic-on-Ceramic Total Hip Arthroplasty with Large Diameter Heads: A Systematic Review

et al. 2020

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“…Arthroscopic tenotomy of the iliopsoas tendon is a minimally invasive method previously reported with improved outcomes and low complication rates when compared to other surgical alternatives [ 6 , 21 , 25 , 31 , 32 ]. Previously, studies have shown up to 92% improved pain scores in patients with IPI after arthroscopic psoas release with less than a 4% complication rate [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Arthroscopic iliopsoas tenotomy after total hip arthroplasty: safe method for the right patient

et al. 2023

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Purpose To evaluate the outcome of arthroscopic treatment for iliopsoas impingement after total hip arthroplasty (THA) 2 years after surgery using patient reported outcomes (PROM). Methods In this study 12 patients (13 hips) were included from a local hip arthroscopy registry. Patients completed web-based PROMs preoperatively and at a minimum of 2 years postoperatively. The PROMs included the International Hip Outcome Tool short version (iHOT-12), the Copenhagen Hip and Groin Outcome Score (HAGOS), the European Quality of Life-5 Dimensions Questionnaire (EQ-5D), the Hip Sports Activity Scale (HSAS) for physical activity level, the Visual Analog Scale (VAS) for overall hip function and a single question regarding overall satisfaction with the surgery. Results The mean age was 64.4 years (±15.1SD), mean body mass index (BMI) was 26.6 (±4.3SD), mean follow-up time was 49.8 months (±25SD). Comparing PROMs preoperatively with 2-year follow up showed an improvement for many of the PROMs used. The PROMs scores were iHOT-12 (24.9 vs 34.5, p = 0.13), HAGOS subscales (symptoms 38.2 vs 54.5, p = 0.05; pain 36 vs 53, p = 0.04; sport 14.1 vs 35.1, p = 0.03; daily activity 31 vs 47.5, p = 0.04; physical activity 21.8 vs 24, p = 0.76; quality of life 24 vs 35, p = 0.03), EQ-VAS (57.9 vs 58, p = 0.08), EQ-5D (0.34 vs 0.13, p = 0.07) and VAS for overall hip function (43.1 vs 46.2, p = 0.14). In total, 10 out of the 12 patients (83%) were satisfied with the intervention. Conclusion Patients undergoing surgery for iliopsoas impingement after previous THA showed improved self-reported hip function where most patients were satisfied with treatment.

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“…The study has notable limitations. First, there is no assessment of the clinical relevance of cup overhanging: cup prominence is a necessary, but not a sufficient predisposing factor leading to psoas impingement [ 4 , 9 ]. Second, no anatomic description of the anterior acetabular wall was provided, thus the shape of the psoas valley (which is another notable causative factor of iliopsoas tendonitis) was not investigated [ 10 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…The planner detailed the cup size, the cup positioning (anteversion, abduction, medialization, center of rotation height, distance between the anterior margin of the native acetabulum and the most anterior surface of the cup on the axial view at the center of the cup), in AHCR and HHCR [ 7 , 8 , 9 ].…”

Section: Methodsmentioning

confidence: 99%

Cup Overhanging in Anatomic Socket Position or High Hip Center of Rotation in Total Hip Arthroplasty for Crowe III and IV Dysplasia: A CT-Based Simulation

Castagnini

Giardina

Fustini

et al. 2023

JCM

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Cup overhanging in total hip arthroplasty is a predisposing factor to iliopsoas impingement. In dysplastic hips, cup implantation was simulated in an anatomic hip center of rotation (AHCR) and in high hip center (HHCR). We sought to assess: (1) the percentage of prominent cups; (2) quantify the cup protrusion at different sites on frontal, axial and sagittal views. In 40 Crowe III-IV hips, using a 3D CT-based planning software, cup planning in AHCR and HHCR (CR height ≥ 20 mm) was performed for every hip. Cup prominence was assessed on every plane. HHCR cups were less anteverted (p < 0.01), less medialized (p < 0.001) and less caudal (p = 0.01) than AHCR sockets. AHCR cups were more frequently prominent on at least one plane (92.5% vs. 77.5%), with minimal agreement between the two configurations (k = 0.31, p = 0.07). AHCR cups protruded more than HHCR sockets in the sagittal (p = 0.02) and axial planes (p < 0.001). Axially, at the center of the cup, prominence 6–11 mm occurred in nine (22.5%) AHCR and one (2.5%) HHCR socket. In conclusion, while a routine high hip center should not be recommended, cup placement at a center of rotation height < 20 mm is associated with higher rates and magnitudes of anterior cup protrusion in severe dysplasia.

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Arthroscopic tendon release for iliopsoas impingement after primary total hip arthroplasty: a retrospective, consecutive series

Cited by 16 publications

References 20 publications

Ceramic-on-Ceramic Total Hip Arthroplasty with Large Diameter Heads: A Systematic Review

Ceramic-on-Ceramic Total Hip Arthroplasty with Large Diameter Heads: A Systematic Review

Arthroscopic iliopsoas tenotomy after total hip arthroplasty: safe method for the right patient

Cup Overhanging in Anatomic Socket Position or High Hip Center of Rotation in Total Hip Arthroplasty for Crowe III and IV Dysplasia: A CT-Based Simulation

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