Competitive Athletes with Femoroacetabular Impingement and Painful Internal Snapping Treated Arthroscopically with Intrabursal Iliopsoas Fractional Lengthening: High Rate of Return to Sport and Favorable Midterm Functional Outcomes
Authors: Jimenez AE, George T, Lee MS, Owens JS, Maldonado DR, Paraschos OA, Lall AC, Domb BG
Journal:American Journal of Sports Medicine, May 2022
DOI: 10.1177/03635465221079844
Background:
Iliopsoas fractional lengthening (IFL) is used to treat painful internal snapping in athletes with FAIS, but long-term functional outcomes have not been well characterized.
Methods:
- Athletes undergoing hip arthroscopy for FAIS with intrabursal IFL (2010–2013) were reviewed.
- Minimum 5-year follow-up for patient-reported outcomes (PROs) and return-to-sport (RTS).
- Compared against a propensity-matched control group without internal snapping.
Key Findings:
- 89.5% of athletes in the IFL group returned to sport.
- Statistically significant improvements in all PROs, including NAHS, HOS-SSS, and VAS (P < .001).
- No differences in outcomes or RTS compared to the control group.
Conclusions:
Intrabursal IFL performed during hip arthroscopy yields durable improvements and a high rate of RTS in athletes with FAIS and painful internal snapping, without compromising outcomes compared to standard procedures.
What Does This Mean for Providers?
When managing athletes with FAIS and internal snapping, intrabursal iliopsoas fractional lengthening during hip arthroscopy is a safe and effective adjunct, supporting long-term functional improvement and RTS. It does not negatively affect outcomes and should be considered for symptomatic snappingMidterm Outcomes of Iliopsoas Fractional Lengthening for Internal Snapping as Part of Hip Arthroscopy for Femoroacetabular Impingement and Labral Tear: A Matched Control Study