Arthroscopic Technique for Iliopsoas Fractional Lengthening for Symptomatic Internal Snapping of the Hip, Iliopsoas Impingement Lesion, or Both
Authors: Chandrasekaran S, Close MR, Walsh JP, Chaharbakhshi EO, Lodhia P, Mohr MR, Domb BG
Journal: Arthrosc Tech. 2018 Aug 16;7(9):e915-e919.
DOI: 10.1016/j.eats.2018.06.001 | PMID: 30258772
Background:
Iliopsoas tendon pathology, including internal snapping hip and iliopsoas impingement, can cause pain and labral injury. Arthroscopic iliopsoas fractional lengthening is a minimally invasive surgical option aimed at symptom relief.
Technique Overview:
- Stepwise arthroscopic approach to fractional lengthening of the iliopsoas tendon.
- Emphasizes comprehensive evaluation and treatment of coexisting intra-articular pathologies such as labral tears and capsular laxity.
- Highlights critical technical considerations to avoid iatrogenic instability and optimize outcomes.
Clinical Implications:
- Provides an effective method for treating internal snapping and impingement lesions with reduced morbidity compared to open procedures.
- Allows simultaneous management of associated intra-articular pathology in a single arthroscopic session.
- Requires careful surgical planning to assess hip stability pre- and intra-operatively.
What Does This Mean for Providers?
Providers should consider arthroscopic iliopsoas fractional lengthening as a viable treatment for patients presenting with symptomatic internal snapping or iliopsoas impingement, particularly when concomitant labral or capsular pathology is present. Mastery of technique and thorough patient selection are critical to achieving optimal clinical outcomes while minimizing complications related to hip instability.