[Arthroscopic treatment of psoas impingement]

Abstract

Objective: Tenotomy of the psoas tendon in symptomatic internal coxa saltans or psoas impingement should relieve pain.

Indications: Indicated in conservative treatment-resistant internal coxa saltans and in psoas impingement.

Contraindications: Contraindications are symptomatic psoas pathologies in hip dysplasia patients.

Surgical technique: Three different procedures exist with the arthroscopic technique, in which the psoas tenotomy can be performed at one of three different levels. These are the arthroscopic transcapsular, the endoscopic extra-articular, and the arthroscopic central techniques.

Postoperative management: Forearm crutches are recommended for approximately 2-4 weeks as well as physiotherapy to strengthen the hip flexors.

Results: A literature-based comparison could reveal no difference between the extra-articular and transcapsular techniques. Particularly in the long term was no loss of strength evident. Various different authors describe the techniques as good, finding neither complications nor recurrence of internal snapping hip.

Keywords: Arthroscopy; Coxa saltans interna; Hip joint; Psoas muscles; Tenotomy.