What happens to endoscopic/arthroscopic tenotomies with iliopsoas impingement in the medium term? Review of a prospective cohort of 64 patients with a minimum follow-up of 5 years - 29/11/23
, Nicolas Bonin c, Mathieu Thaunat d, Jean-Emmanuel Gédouin e, Xavier Flecher f, Michael Wettstein g, Willaume Guicherd c, Nicolas Prevot h, Olivier May iThe Francophone Arthroscopy Society (SFA)j
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Abstract |
Introduction |
The occurrence of iliopsoas impingement (IPI) after total hip arthroplasty (THA) is a proven risk factor for negative outcomes. Endoscopic or arthroscopic tenotomies of the iliopsoas offer a surgical solution with short-term results that have already been validated in prospective multicenter series. We carried out a review of the patients at more than 5 years of follow-up in order to assess the stability of the results over time.
Hypothesis |
Our main hypothesis was that endoscopic/arthroscopic tenotomies allow stable medium-term resolution of the painful symptoms of IPI. Our secondary hypothesis was that medium-term survival was satisfactory.
Material and method |
This study is a continuation of a multicenter prospective series. Patients were contacted through multiple channels in order to: obtain an Oxford score, assess for satisfaction, psoas irritation, and daily pain on a visual analogue scale (VAS).
Results |
Of 64 patients in the original study, 57 were contacted. The Oxford score at the last follow-up was 40.7±7.7 [12–48]. There was a significant difference between the Oxford scores preoperatively, at 8 months and at the last follow-up. The mean satisfaction out of 10 was 8.0±2.1 [1–10]. We found 84% satisfaction at 5 years against 83% at 8 months. The VAS was 2.1±2.3 [0–10]. A straight leg psoas sign was present in 19.6% (10/51) of patients at 5 years, compared to 15.6% (8/51) at 8 months. The sign disappeared in four cases, while it reappeared during the interval in six cases. Survival was 91.2% (95% CI: 80.2–96.3) at 5 years.
Conclusion |
Endoscopic/arthroscopic iliopsoas tenotomies represent a permanent medium-term solution to treat IPI after THA. The existence of a force differential or an acetabular overhang does not seem, within a certain limit, to impact the results in the medium term.
Level of evidence |
IV; prospective series without control group.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Iliopsoas cup impingement, Tenotomy, Hip arthroscopy, Total hip arthroplasty
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Vol 109 - N° 8S
Articolo 103687- dicembre 2023 Ritorno al numero
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Benvenuto su EM|consulte, il riferimento dei professionisti della salute.