Iliopsoas Impingement After Primary Total Hip Arthroplasty: Operative and Nonoperative Treatment Outcomes

Chalmers, Brian P.; Sculco, Peter K.; Sierra, Rafael J.; Trousdale, Robert T.; Berry, Daniel J.

doi:10.2106/jbjs.16.00244

Cited by 108 publications

(118 citation statements)

References 17 publications

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“…Vandenbussche et al reported that the depth of the psoas valley is approximately 4 mm from the acetabular equator [1,2], which is almost the same as the degree of superomedialization in the acetabula when reaming during a THR [20]. Therefore, pre-and intra-operative assessment of the psoas valley is essential to avoid postoperative iliopsoas impingement which is becoming a major issue following arthroplasty [21][22][23].…”

Section: Discussionmentioning

confidence: 99%

Anatomical variation of the Psoas Valley: a scoping review

Kuroda

Rai

Saito

et al. 2020

BMC Musculoskelet Disord

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Background: This scoping review aimed to investigate the literature on the anatomy of the psoas valley, an anterior depression on the acetabular rim, and propose a unified definition of the anatomical structure, describe its dimensions, anatomical variations and clinical implications. Methods: A systematic computer search of EMBASE, PubMed and Cochrane for literature related to the psoas valley was undertaken using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Clinical outcome studies, prospective/retrospective case series, case reports and review articles that described the psoas valley and its synonyms were included. Studies on animals as well as book chapters were excluded. Results: Of the 313 articles, the filtered literature search identified 14 papers describing the psoas valley and its synonyms such as iliopsoas notch, a notch between anterior inferior iliac spine and the iliopubic eminence, Psoas-U and anterior wall depression. Most of these were cross-sectional studies that mainly analyzed normal skeletal hips. In terms of anatomical variation, 4 different configurations of the anterior acetabular rim have been identified and it was found that the curved type was the most frequent while the straight type may be nonexistent. Additionally, the psoas valley tended to be deeper in males as compared with females. Several papers established the psoas valley, or Psoas-U in a consistent location at approximately 3 o'clock on the acetabular rim which may have implications with labral pathology. Conclusion: This review highlights the importance of the anatomy of the psoas valley which is a consistent bony landmark. The anatomy and the anatomical variations of the psoas valley need to be well-appreciated by surgeons involved in the management of young adults with hip pathology and also joint replacement surgeons to ensure appropriate seating of the acetabular component.

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Section: Discussionmentioning

confidence: 99%

Anatomical variation of the Psoas Valley: a scoping review

Kuroda

Rai

Saito

et al. 2020

BMC Musculoskelet Disord

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“…A retrospective review of 49 patients [6] who had been treated for iliopsoas impingement after a primary total hip arthroplasty with 4 years of mean followup show 50% (10 patients) in the nonoperative group had groin pain resolution as compared to 76% (22 patients) in the operative group (p = 0.06). The patients with <8 mm of component prominent tenotomy stated 100% resolution of groin pain (5 patients) but patients with ≥8 mm of prominent tenotomy led to groin pain resolution at only 33% (3 patients).…”

Section: Discussionmentioning

confidence: 99%

“…Nowadays, total hip replacements (THR) are increasing in numbers and indications [5]. An iliopsoas impingement can be a complication of this procedure from impingement of the iliopsoas tendon with the acetabular component [6,7] (Figure 3). This is noticeable in the large size of the acetabular components or in patients with dysplastic morphology of the native hip associated with under coverage of the anterior/superior acetabular rim.…”

Section: Introductionmentioning

confidence: 99%

“…The surgical treatment consists of iliopsoas release via an open, arthroscopic or endoscopic approach with or without intra-articular procedures. In the total hip replacement patient with obvious acetabular component malposition or prominence, acetabular cup revision maybe necessary [6]. For the arthroscopic/endoscopic iliopsoas release techniques, these can be performed using: 1. the transcapsular release (proximal arthroscopic release) via the central or peripheral compartment and 2. releasing at the lesser trochanteric level (distal endoscopic release) ( Figure 5).…”

Section: Introductionmentioning

confidence: 99%

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Arthroscopic and Endoscopic Management of the Internal Snapping Hip Syndrome

Apivatgaroon¹

2020

Essentials in Hip and Ankle

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Internal snapping hip syndrome or coxa saltans interna results from the iliopsoas tendon snapping over the superior pubic ramus, iliopectineal eminence, anterior hip joint, femoral head or the lesser trochanter. This condition occurs in either the native hip or a prosthetic hip joint. Conservative management is the mainstay treatment, but iliopsoas release continues to be the definitive treatment in patients with failed conservative measures. The arthroscopic iliopsoas release from the central or peripheral compartment is useful in the management of internal snapping syndrome and may have less hip flexion strength deficits postoperatively as compared to the releasing from the lesser trochanteric level. Endoscopic iliopsoas release at the lesser trochanter level is the preferred operative treatment option for internal snapping patients who have undergone a total hip replacement.

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“…As for other factors, Vandenbussche et al reported that the depth of the psoas valley is approximately 4 mm from the acetabular equator [1,2], which is almost the same as the degree of superomedialisation in the acetabulae when reaming during a THR [19]. Therefore, pre-and intra-operative assessment of the psoas valley is essential to avoid postoperative iliopsoas impingement which is becoming a major issue following arthroplasty [20][21][22].…”

Section: F) Related Factorsmentioning

confidence: 99%

Anatomical Variation of the Psoas Valley: A Scoping Review

Kuroda

Rai

Saito

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: The aim of this scoping review was to investigate the literature on the anatomy of the psoas valley, an anterior depression on the acetabular rim, and propose a unified definition of the anatomical structure, describe its dimensions, anatomical variations and clinical implications. Methods: A systematic computer search of EMBASE, PubMed and Cochrane for literature related to the psoas valley was undertaken using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Clinical outcome studies, prospective/retrospective case series, case reports and review articles that described the psoas valley and its synonyms were included. Studies on animals as well as book chapters were excluded. Results: Of the 313 articles, the filtered literature search identified 14 papers describing the psoas valley and its synonyms such as iliopsoas notch, notch between anterior inferior iliac spine and the iliopubic eminence, Psoas-U and anterior wall depression. Most of these were cross-sectional studies that mainly analysed normal skeletal hips. In terms of anatomical variation, 4 different configurations of the anterior acetabular rim have been identified and it was found that the curved type was the most frequent while the straight type may be nonexistent. Additionally, the psoas valley tended to be deeper in males as compared with females. Several papers established the psoas valley, or Psoas-U in a consistent location at approximately the 3 o'clock on the acetabular rim which may have implications with labral pathology. Conclusion: This review highlights the importance of the anatomy of the psoas valley which is a consistent bony landmark. The anatomy and the anatomical variations of the psoas valley need to be well-appreciated by surgeons involved in the management of young adults with hip pathology and also joint replacement surgeons to ensure appropriate seating of the acetabular component.

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Iliopsoas Impingement After Primary Total Hip Arthroplasty: Operative and Nonoperative Treatment Outcomes

Abstract: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Cited by 108 publications

References 17 publications

Anatomical variation of the Psoas Valley: a scoping review

Anatomical variation of the Psoas Valley: a scoping review

Arthroscopic and Endoscopic Management of the Internal Snapping Hip Syndrome

Anatomical Variation of the Psoas Valley: A Scoping Review

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