Surgical release of the 'snapping iliopsoas tendon'

Abstract

We report 22 patients (19 women and three men) of mean age 20.8 years who had painful snapping sensations in the groin. Most were able to reproduce the click by extending the affected hip from a flexed, abducted and externally rotated position and most were tender in the adductor triangle. Plain radiographs and an arthrogram were normal. A clinical diagnosis of subluxation of the iliopsoas tendon was made. Conservative management failed in 14 patients, two of whom had bilateral pain. All 14 had surgical release of the iliopsoas tendon through a medial approach. At follow-up (mean 17 months) the click had resolved in ten hips, was occasional but painless in five and unchanged in one. The syndrome of a painful 'snapping' psoas may result in disproportionately disabling symptoms. It may be diagnosed on clinical grounds and effectively treated, when severe, by release of the iliopsoas tendon.

Massive Heterotopic Ossification Complicating Iliopsoas Tendon Lengthening

“…These include anterior, ilioinguinal, iliofemoral, medial, and endoscopic approaches. [2][3][4]6,10,13 Success rates of between 85% and 100% have been reported. However, in long-term follow-up, the overall complication rate has been reported to be as high as 40% to 50% with the open approaches.…”

An external snapping hip caused by osteochondroma of the proximal femur

“…3,4 The etiology of the internal type is still poorly understood in comparison to the external type. [5][6][7][8][9][10][11] An internal snapping hip occurs just as the iliopsoas tendon slips over the iliopectineal eminence or over the femoral head. Iliopsoas tendon fractional lengthening has been recognized to be an effective treatment modality.…”

“…Iliopsoas tendon fractional lengthening has been recognized to be an effective treatment modality. [5][6][7]10 The intra-articular type is caused by an intracapsular lesion. 9,12 A loose body or a torn labrum can be the cause of this type, and arthroscopy is a useful tool for both the diagnosis and treatment of such cases.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12] Snapping hip is distinguished into two types, namely an intra-articular type and an extraarticular type. 8,9 The extra-articular type can be further delineated into three types, namely, external (lateral), internal (medial), and posterior.…”

The anatomy and relevance of the iliopsoas in the young adult with hip pain: Role of arthroscopic intervention

“…8,35 The main procedures described are tendon decompression, step lengthening of the iliopsoas tendon 22,27,29,33 and iliopsoas tendon release. 28,43 Hip arthroscopy also has the added benefit of allowing visualisation and treatment of any associated intra-articular pathology, which has been reported in more than half of patients undergoing hip arthroscopy for internal snapping hip syndrome. 4,35 It is also less invasive which allows earlier rehabilitation and return to function.…”