An Iliopsoas Impingement Lesion in the Absence of Painful Internal Snapping May Not Require Iliopsoas Fractional Lengthening

An Iliopsoas Impingement Lesion in the Absence of Painful Internal Snapping May Not Require Iliopsoas Fractional Lengthening

Authors: Meghpara MB, Bheem R, Diulus SC, Rosinsky PJ, Shapira J, Maldonado DR, Lall AC, Domb BG

DOI: 10.1177/0363546520944147

Background:

Iliopsoas impingement (IPI) can present with painful internal snapping (PIS) and may require iliopsoas fractional lengthening (IFL). This study evaluates if IFL is necessary when IPI lesions occur without painful snapping.

Methods:

Comparison of outcomes in patients with IPI lesions with and without PIS, some undergoing IFL and others not, with minimum 2-year follow-up.

Key Findings:

• Patients without PIS who did not receive IFL had outcomes comparable to those with PIS who underwent IFL.
• Both groups showed significant improvement in hip function and satisfaction.

Conclusions:

IFL may be unnecessary in patients with IPI lesions lacking painful internal snapping, allowing for more tailored surgical intervention.

What Does This Mean for Providers?

Assess the presence of painful internal snapping before deciding on IFL during hip arthroscopy for IPI. Avoid routine IFL in patients without snapping to reduce surgical morbidity while still achieving good outcomes.