Iliopsoas Release: A Systematic Review of Clinical Efficacy and Associated Complications

Abstract

Objective: To perform a systematic review of the findings of iliopsoas release as it relates to resolution of snapping, improvement of groin pain, and associated complications. Design: Systematic review. Data Sources: Four electronic databases PubMed/MEDLINE, EMBASE, CINAHL, and Web of Science were searched, identifying all literature pertaining to surgical treatment of a snapping hip/coxa saltans, iliopsoas impingement, or iliopsoas tendinitis. A total of 818 studies were identified. Two reviewers independently screened the titles, abstracts, and full-text articles for eligibility. Eligibility Criteria: All studies published in English that reported on iliopsoas release for snapping hip/coxa saltans, iliopsoas impingement, or iliopsoas tendinitis reporting outcomes or associated complications were eligible. Results: A total of 48 articles were included in this review. Three surgical indications were identified for iliopsoas release, internal snapping hip, labral tear secondary to iliopsoas impingement, and iliopsoas tendinopathy after total hip arthroplasty. Arthroscopic techniques seemed to be superior to open techniques with regards to reoccurrence of snapping (5.1% vs 21.7%) and groin pain relief (89.1% vs 85.6%) with fewer complications (4.2% vs 21.1%) overall. Conclusions: Both open and arthroscopic iliopsoas releases have been shown to be successful treatment options regardless of the surgical indications identified in this review. Arthroscopic release demonstrated a decreased failure rate, fewer complications, and improved outcomes when compared with open procedures.

An interesting case of external type of coxa saltans treated by z plasty of iliotibial band-a case report

“…Though arthroscopic techniques have advantages of minimally invasive ness and less soft tissue dissection, open Z plasty is still routinely used due to clear identification of landmarks and easy learning curve compared to arthroscopic technique. [7][8][9] Interpretations obtained are similar to those shown in previous studies. 6 Our patient showed good symptomatic relief following surgery with complete resolution of previous symptoms.…”

The role of iliopsoas fractional lengthening in hip arthroscopy: a systematic review

“…and Longstaffe et al . in 2021 regarding the effectiveness of arthroscopic release of the iliopsoas tendon (IFL) for the treatment of ISHS [ 3 , 11 ]. Since the cutoff for these systematic reviews in 2018, six additional level 3 comparative cohort studies have provided significant clinical insights into the use of IFL.…”

“…Arthroscopic iliopsoas release is a minimally invasive surgical option that involves releasing the iliopsoas tendon to reduce friction and snapping in the hip joint [ 3 ]. Despite the well-defined arthroscopic techniques, there still remain several controversial aspects of the procedure.…”

“…Despite the well-defined arthroscopic techniques, there still remain several controversial aspects of the procedure. The release of the iliopsoas carries inherent risks and has the potential to heighten instability or lead to intraabdominal fluid extravasation [ 3 ]. Surgeons often run into the question of whether to combine iliopsoas releases with their arthroscopic labral repairs when a patient has a concomitant internal snapping hip pathology.…”