Endoscopic Tendon Release for Iliopsoas Impingement After Total Hip Arthroplasty—Excellent Clinical Outcomes and Low Failure Rates at Short-Term Follow-Up

Finsterwald, Michael; Mancino, Fabio; Waters, Georgina; Ebert, Jay R.; Malik, Shahbaz S.; Jones, Christopher; Yates, Piers; D’Alessandro, Peter

doi:10.1016/j.arthro.2023.07.040

Cited by 5 publications

(3 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, 3D reconstruction of the acetabular anatomy in the coronal, sagittal, and axial plane enables greater accuracy of implant positioning in relation to both the anterior and posterior walls. This approach can facilitate a full ROM while minimizing the risk of anterior overhang, potentially triggering postoperative pain and impingement of the iliopsoas tendon 16 , 17 ) . Considering the importance of version of the acetabular component for achievement of optimal outcomes 18 ) , accurate visualization of the posterior coverage can be helpful in the effort to ensure the correct position of the cup in the axial plane 19 ) .…”

Section: Preoperative Ct-based Planningmentioning

confidence: 99%

Section: Preoperative Ct-based Planningmentioning

confidence: 99%

See 1 more Smart Citation

The Value of Computed Tomography Scan in Three-dimensional Planning and Intraoperative Navigation in Primary Total Hip Arthroplasty

Mancino,

Fontalis,

Magan

et al. 2024

Hip & Pelvis

Self Cite

View full text Add to dashboard Cite

Total hip arthroplasty (THA) is a frequently performed procedure; the objective is restoration of native hip biomechanics and achieving functional range of motion (ROM) through precise positioning of the prosthetic components. Advanced three-dimensional (3D) imaging and computed tomography (CT)-based navigation are valuable tools in both the preoperative planning and intraoperative execution. The aim of this study is to provide a thorough overview on the applications of CT scans in both the preoperative and intraoperative settings of primary THA. Preoperative planning using CT-based 3D imaging enables greater accuracy in prediction of implant sizes, leading to enhancement of surgical workflow with optimization of implant inventory. Surgeons can perform a more thorough assessment of posterior and anterior acetabular wall coverage, acetabular osteophytes, anatomical landmarks, and thus achieve more functional implant positioning. Intraoperative CT-based navigation can facilitate precise execution of the preoperative plan, to attain optimal positioning of the prosthetic components to avoid impingement. Medial reaming can be minimized preserving native bone stock, which can enable restoration of femoral, acetabular, and combined offsets. In addition, it is associated with greater accuracy in leg length adjustment, a critical factor in patients’ postoperative satisfaction. Despite the higher costs and radiation exposure, which currently limits its widespread adoption, it offers many benefits, and the increasing interest in robotic surgery has facilitated its integration into routine practice. Conducting additional research on ultra-low-dose CT scans and examining the potential for translation of 3D imaging into improved clinical outcomes will be necessary to warrant its expanded application.

show abstract

Section: Preoperative Ct-based Planningmentioning

confidence: 99%

Section: Preoperative Ct-based Planningmentioning

confidence: 99%

The Value of Computed Tomography Scan in Three-dimensional Planning and Intraoperative Navigation in Primary Total Hip Arthroplasty

Mancino,

Fontalis,

Magan

et al. 2024

Hip & Pelvis

Self Cite

View full text Add to dashboard Cite

show abstract

“…Diagnosis of iliopsoas tendinopathy following THA is challenging [25] and requires ruling out other causes of groin pain, through a sequence of clinical, imaging and blood tests. If nonsurgical treatments fail, surgical options, such as acetabular cup revision [1,35] or iliopsoas tenotomy (performed through an open, arthroscopic or endoscopic approach [2,3,7,9,15,26,33,36], can relieve pain and restore function. Iliopsoas tenotomy is less invasive than acetabular cup revision, and a recent study by Shapira et al [36] has shown that it can provide similar or better clinical outcomes, with fewer complications.…”

Section: Introductionmentioning

confidence: 99%

Satisfactory mid‐term clinical outcomes of endoscopic tenotomy for iliopsoas tendinopathy following total hip arthroplasty

Erard,

Viamont‐Guerra,

Bonin

2024

Knee surg. sports traumatol. arthrosc.

View full text Add to dashboard Cite

PurposeTo report 5‐year outcomes of endoscopic iliopsoas tenotomy in patients with iliopsoas tendinopathy following total hip arthroplasty (THA) and determine whether clinical scores are associated with cup position.MethodsPatients who underwent endoscopic iliopsoas tenotomy for iliopsoas tendinopathy following THA (2014–2017) were contacted. Indications for endoscopic iliopsoas tenotomy after THA were groin pain during active hip flexion, exclusion of other causes of groin pain, and no pain relief after 6 months of conservative treatment. Pretenotomy cup inclination and anteversion were measured on radiographs; axial and sagittal cup overhang were measured on computed tomography (CT) scans. Oxford hip score (OHS), modified Harris hip score (mHHS), and groin pain were assessed.ResultsThe initial cohort comprised 16 men (17 hips) and 31 women (32 hips), aged 60.7 ± 10.6 years. Cup inclination and anteversion were, respectively, 46.2 ± 6.2° and 14.6 ± 8.4°, while axial and sagittal cup overhang were, respectively, 4.4 ± 4.0 mm and 6.9 ± 4.5 mm. At ≥5 years follow‐up, four hips underwent cup and stem revision, two underwent isolated cup revision and one underwent secondary iliopsoas tenotomy. OHS improved by 23 ± 10 and mHHS improved by 31 ± 16. Posttenotomy groin pain was slight in 20.0%, mild in 17.5% and moderate in 12.5%. Regression analyses revealed that net change in mHHS decreased with sagittal cup overhang (β = –3.1; 95% confidence interval [CI] = –4.6 to –1.7; p < 0.001), but that there were no associations between cup position and net change in OHS.ConclusionsEndoscopic iliopsoas tenotomy provides good mid‐term clinical outcomes in patients with iliopsoas tendinopathy following THA. Furthermore, improvements in mHHS were found to decrease with increasing sagittal cup overhang, in cases for which adequate preoperative imaging was available.Level of EvidenceLevel IV.

show abstract

Arthroscopic and endoscopic techniques for iliopsoas release in THA are safe and effective: a systematic review of the literature

Giai Via,

Giachino,

Elzeiny

et al. 2024

Eur J Orthop Surg Traumatol

View full text Add to dashboard Cite

Background Hip replacement surgery is highly effective in relieving pain and improving mobility in patients with various hip conditions. However, some patients develop groin pain after surgery, often due to iliopsoas impingement (IPI), which can be challenging to diagnose. Conservative treatments are initially recommended, but when these are not effective, surgical options may be considered. This study aims to evaluate the clinical outcomes, success and failure rates, revision rates, and complications associated with arthroscopic and endoscopic surgery for IPI, thereby providing a comprehensive understanding of the effectiveness and risks of these surgical interventions. Materials and methods A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, including a thorough search of five main databases: PubMed, Scopus, Embase, Medline, and Cochrane. Eligible articles were meticulously evaluated according to predefined criteria for levels of evidence (LoE), with retrospective studies assessed using the Coleman Methodology Score (mCMS). This systematic review was registered in the International Prospective Registry of Systematic Reviews (PROSPERO). Results Among the 16 included studies, 431 patients with 434 hips underwent either endoscopic or arthroscopic tenotomy. Both techniques showed favorable outcomes, with arthroscopic tenotomy demonstrating slightly higher success rates than endoscopic tenotomy. Common complications included mild pain and occasional infections, with recurrence observed in some cases. Both techniques offer direct visualization of prosthetic components and potential preservation of psoas function. Conclusions Arthroscopic and endoscopic iliopsoas tenotomy are effective treatments for alleviating symptoms and improving hip function in patients with IPI post-total hip arthroplasty (THA). Level of evidence IV.

show abstract

Endoscopic Tendon Release for Iliopsoas Impingement After Total Hip Arthroplasty—Excellent Clinical Outcomes and Low Failure Rates at Short-Term Follow-Up

Cited by 5 publications

References 40 publications

The Value of Computed Tomography Scan in Three-dimensional Planning and Intraoperative Navigation in Primary Total Hip Arthroplasty

The Value of Computed Tomography Scan in Three-dimensional Planning and Intraoperative Navigation in Primary Total Hip Arthroplasty

Satisfactory mid‐term clinical outcomes of endoscopic tenotomy for iliopsoas tendinopathy following total hip arthroplasty

Arthroscopic and endoscopic techniques for iliopsoas release in THA are safe and effective: a systematic review of the literature

Contact Info

Product

Resources

About