Endoscopic Resection for Iliopectineal Bursitis Associated With Developmental Dysplasia of the Hip

Abstract

Iliopectineal bursitis usually develops subsequent to other hip pathologies and can often be treated conservatively. However, when conservative treatment fails or the enlarged bursa causes pain or compression of the surrounding neurovascular structures, surgery may be required. Most previous studies have described open surgeries, and reports on endoscopy are very limited. We present a case of iliopectineal bursitis associated with developmental dysplasia of the hip (DDH) that was successfully treated endoscopically. A 16-year-old female with a one-year history of right inguinal pain was referred to our department. She was diagnosed with a hip ganglion and treated with needle aspiration nine times by her previous doctor. Radiographs revealed bilateral DDH without narrowing of the joint space. Magnetic resonance imaging revealed a distinct mass in the deep layer of the iliopsoas muscle, and communication between the mass and the hip joint was observed on ultrasonography. Endoscopic debridement and resection were performed based on the diagnosis of iliopectineal bursitis. We partially debrided the medial side of the rectus femoris muscle toward the deep layer and resected the bursa. We observed a burst of concentrated content from the bursa and confirmed the disappearance of the mass by intraoperative ultrasonography. The postoperative course was good, and there were no functional restrictions or symptom recurrence at two-year postoperatively. Endoscopic resection for repetitive iliopectineal bursitis without an intraarticular procedure does not induce hip instability in patients with DDH and is a minimally invasive cosmetic procedure, and superior to open surgery, especially in young women.

Sequential Treatment of Iliopsoas Tendon Cysts Combined With Medial Hip Snapping by Hip Arthroscopy

“…The iliopsoas bursa is connected to the adjacent hip joint cavity, and the junction is located between the pubofemoral ligament and the iliofemoral ligament. 1 Tension of the iliopsoas tendon, pincer deformity, and glenoid labral injury may result in iliopsoas bursae penetrating into the joint cavity, resulting in fluid accumulation into the medial iliopsoas tendon, forming cysts. 2 Cysts in the iliopsoas muscle indicate abnormalities in the iliopsoas muscle or its adjacent structures.…”