Iliopsoas stretch1/27/2024 No complications or repeat revisions took place. In the acetabular revision group, among patients with cup prominence ≥ 8 mm (n = 13), 92 percent achieved resolution of groin pain compared to half of patients (n = 4/8) with cup prominence < 8 mm. The researchers used direct lateral radiographs to measure anterior-inferior acetabular component prominence.Īmong the nonoperative patients, about half achieved resolution of groin pain. Twenty patients received nonoperative treatment, and 29 underwent surgery-either acetabular revision (n = 21) or iliopsoas tenotomy (n = 8). The retrospective review included 49 patients treated between 19 patients were excluded if they had sepsis, revision THA, or metal-on-metal bearing. “A few years ago, we looked up a relatively large series of patients that had iliopsoas tendonitis ,” Dr. “Previous recommendations are based on small case reports or very small series” with short follow-up, said Dr. … There’s really no consensus on those treatment options,” he added. “If that fails and the pain is bad enough, then you have to discuss either tenotomy or cup revision. Nonoperative management may include psoas injections, nonsteroidal anti-inflammatory drugs, and physical therapy. Once diagnosis is confirmed, patients can be managed operatively or nonoperatively. Trousdale said, adding it is “very technique-dependent on who does this.” The diagnosis can be confirmed with CT-guided scan or ultrasound-guided iliopsoas sheath injection, Dr. Other possible causes of groin pain must be ruled out, including: increase the patient’s offset dramatically, it’ll stretch the tendon.” Extra large femoral heads also can lead to iliopsoas impingement. “If you lengthen the leg tremendously, then you have psoas tension and pain problems. “If you retrovert the socket, if you lateralize the socket, if you anteriorize the socket,” iliopsoas impingement could occur, he said. Several factors-notably pertaining to the anterior acetabular rim-could cause iliopsoas impingement. It is diagnosed through a physical examination that includes a psoas stretch test. Hip flexion activities-such as walking up and down stairs and getting in and out of a car-often intensify the pain. Patients frequently complain of pain in the groin, which may radiate to the thigh and is not always constant. ![]() And despite increased awareness of the problem, it remains commonly missed among THA patients. The incidence of iliopsoas impingement is about 4.3 percent, Dr. ![]() Trousdale, MD, professor of orthopaedics at Mayo Clinic in Rochester, Minn., discussed diagnosis, management, treatment, and prevention of iliopsoas impingement after total hip arthroplasty (THA). During the AAOS 2019 Annual Meeting, Robert T.
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