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• W2064291233 abstract "Snapping ilio-psoas tendon is a rare condition caused by a sudden slip of the ilio-psoas tendon over the iliopectineal eminence, it is underdiagnosed and may be related to sport activity or hip pathology. Open surgical lengthening and release have been used with success to treat this condition. The purpose or this study is to report the short-term results of an endoscopic ilio-psoas tendon release technique. Methods: Between January 2002 and August 2003 we treated 12 patients for symptomatic anterior snapping hip, 6 patients (7 hips) did not respond to physical therapy, surgical treatment was indicated, all were female with an average age of 38.5 years (26 to 44). The diagnosis was related to sports in 2 cases, developmental dysplasia of the hip in 2 (no previous surgery) and 1 had no positive history. Four hips were left and 3 right. Endoscopic psoas release was performed after hip joint arthroscopy by the lateral approach, traction was used for acetabular and superior femoral head visualization trough 3 standard portals. The inferior hip capsule and the psoas bursa were examined without traction. The inferior hip capsule was visualized trough an anterior inferior portal (with fluoro control); no working portal was necessary for any case at this point. To access the psoas bursa the leg was externally rotated to visualize the lesser trochanter at the image intensifier. The arthroscopic cannula was introduced in the anterior inferior portal and directed to the lesser trochanter (fluoro control), the ilio-psoas tendon was identified arthroscopically and a further inferior portal was made triangulating toward the lesser trochanter. A slotted cannula was placed at the most inferior portal and the ilio-psoas tendon was released with electrocautery. Full range of motion and weight bearing were allowed after surgery except for one case that had microfractures done. Results: We were able to identify and release the ilio-psoas tendon in every case, associated injuries were identified and treated in 4 cases, these included Outerbridge II lesions on the acetabulum in 1 case. Two cases with inverted labrums one with exposed subchondral bone at the anterior acetabular rim and one case with hypertrophy of ligamentum teres. All the patients were relieved of symptoms and pain immediately after surgery but they were unable to do a straight leg raise or climb steps until 6 to 8 weeks. Discussion: Open ilio-psoas tendon release is a well-known procedure, loss of flexion strength in the hip can be significant and may not be suited for the young sports-active patient, open tendon lengthening is a good option but may be insufficient and snapping symptoms may not be fully relieved. We present an endoscopic technique which is safe and reproducible and seems to be effective in the treatment of the symptoms of the snapping ilio-psoas tendon. Loss of flexion strength was present in all cases and recovered to a functional level in 8 weeks. Longer follow-up and larger series are needed to fully evaluate this procedure." @default.
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• W2064291233 date "2004-05-01" @default.
• W2064291233 modified "2023-09-27" @default.
• W2064291233 title "Arthroscopic release of the “snapping ilio-psoas tendon” (SS-90)" @default.
• W2064291233 doi "https://doi.org/10.1016/j.arthro.2004.02.092" @default.
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