Arthroscopic Iliopsoas Fractional Lengthening
Authors: Maldonado DR, Lall AC, Battaglia MR, Laseter JR, Chen JW, Domb BG
Background:
- Internal snapping hip syndrome is commonly due to iliopsoas tendon friction over the femoral head, especially in active individuals. When nonoperative management fails, surgical intervention is considered.
Methods:
- IFL was performed arthroscopically in a supine position under traction. A complete transverse cut of the tendinous portion of the iliopsoas tendon was executed through standard portals.
Key Findings:
- Arthroscopic IFL is effective in relieving symptomatic internal snapping and can be performed safely with other procedures such as labral repair or FAI correction.
- Minimally invasive nature supports faster recovery and reduced soft-tissue disruption compared to open approaches.
What Does This Mean for Providers?
- IFL is a reproducible arthroscopic technique for internal snapping hip unresponsive to conservative care.
- Consider IFL particularly in cases with microinstability or concomitant pathology that necessitates intra-articular access.
- Proper patient selection is essential to avoid overlengthening and subsequent hip flexor weakness.