Arthroscopic Iliopsoas Release at the Level of the Lesser Trochanter Following Total Hip Arthroplasty

Abstract

Iliopsoas impingement is an uncommon cause of pain after total hip arthroplasty. If pain persists after a trial of conservative treatment, surgical intervention can alleviate the patient's symptoms. Multiple advantages exist to release the iliopsoas tendon at the level of the lesser trochanter. The purpose of this Technical Note is to demonstrate a technique for arthroscopic release of the iliopsoas tendon at the lesser trochanter after total hip arthroplasty.

Snapping Hip Syndrome: A Comprehensive Update

“…The lesser trochanter approach yielded no complications apart from the loss of flexion strength that improved by eight weeks after the procedure. 41,48 Hwang et al had good results with the transcapsular approach in 24 out of 25 patients, all of whom had lost flexion strength postoperatively for six weeks. All patients returned to their previous activity level within ten weeks, and 24 out of 25 patients noted improvement.…”

“…Due to the proximity of lesser trochanter to femoral neurovascular structures, the lesser trochanter approach is thought to have greater risk than the transcapsular approach. 48 Patel et al and Ilizaliturri et al describe a case series of ten and six patients, respectively. The lesser trochanter approach yielded no complications apart from the loss of flexion strength that improved by eight weeks after the procedure.…”