Arthroscopic psoas release for iliopsoas impingement after total hip replacement

Abstract

Psoas impingement is a rare cause of persisting pain after hip arthroplasty. Diagnosis is based on clinical examination and exclusion of other complications after arthroplasty by radiographs, ultrasound, CT and blood analysis. The diagnosis is strongly supported by temporary pain relief after infiltration. When conservative measures fail, treatment can consist of a psoas tenotomy or a revision arthroplasty. When there is no obvious cause such as malpositioning for component impingement, psoas release reliably improves pain and function. This procedure is mostly performed through an open approach, which can give significant complications. An arthroscopic technique for psoas tenotomy after hip arthroplasty is described. This report shows that this minimal invasive technique is safe and effective and allows for inspection of the implant in the same session. However, the score used did not improve in a significant way.