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. 2024 Apr 16;13(5):102925.
doi: 10.1016/j.eats.2024.102925. eCollection 2024 May.

Sequential Treatment of Iliopsoas Tendon Cysts Combined With Medial Hip Snapping by Hip Arthroscopy

Yanlin Li  1 , Hong Yv  1 , Rongqian Ni  2 , Yatong Liao  1 , Zhen Qin  3 , Di Jia  1
Affiliations

Sequential Treatment of Iliopsoas Tendon Cysts Combined With Medial Hip Snapping by Hip Arthroscopy

Yanlin Li et al. Arthrosc Tech. .

Abstract

Tendon cysts of the iliopsoas muscle cause pain and snapping of the hip. These cysts are close to the femoral nerve and blood vessels, and the risk of open surgery is high, with cyst recurrence occurring frequently. We describe a method of hip arthroscopy for the orderly excision of iliopsoas cysts. During the operation, the iliopsoas tendon is identified and released, the cyst is excised, and peritendinous osteophytes are formed successively. This technique is a minimally invasive, safe, and highly effective hip arthroscopy technique that addresses both intra- and extra-articular lesions.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: D.J. was supported by PhD start-up Fund of the First Affiliated Hospital of Kunming Medical University (2019BS008) and the Major Science and Technology Project of Yunnan Provincial Department of Science and Technology, Yunnan Provincial Orthopedic and Sports Rehabilitation Clinical Medicine Research Center (202102AA310068). All other authors (Y. Li, H.Y., R.N., Y. Liao, Z.Q.) declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig 1
Fig 1
Preoperative magnetic resonance imaging of right hip joint. (A) The presurgical cyst’s long axis is 8.03 cm and its transverse axis is 2.64 cm in the coronal view. (B) The distances of the articular cavity from the femoral artery and femoral vein are 3.66 cm and 3.56 cm, respectively, in the transverse view.
Fig 2
Fig 2
Surgical approach and marking of tender point in right hip. (A) Anterolateral (AL), middle anterior (MA), and distal anterolateral accessory (DALA) portals are used for the surgical approach. (B) The body surface location of the tender point is marked.
Fig 3
Fig 3
Right hip with patient in supine position. Arthroscopic identification of tense iliopsoas tendon from anterolateral portal.
Fig 4
Fig 4
Arthroscopic view from anterolateral portal of right hip with patient in supine position. (A) Pincer deformity and synovial congestion are seen around the iliopsoas tendon. (B) A spherical grinding drill is used to polish the peritendon osteophytes. (C) The iliopsoas tendon is released. (D) Blood sac fluid can be seen flowing from the medial area of the tendon after release. (E) When the camera enters the medial area of the tendon, a synovial chondroma forms inside the cyst wall. (F) A radiofrequency device is used to clean the cyst wall.
Fig 5
Fig 5
(A) Cam arthroplasty is performed after the joint capsule is dissected longitudinally. (B) The joint capsule is sutured to protect joint stability.
Fig 6
Fig 6
Postoperative magnetic resonance imaging of the right hip joint shows that the cyst is cleanly resected. (A) The cyst completely disappears in the coronal view. (B) The distances of the articular cavity from the femoral artery and femoral vein are 22.82 mm and 26.87 mm, respectively, in the transverse view.
See this image and copyright information in PMC

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