American Hip Institute

2011 – Iliopsoas impingment newly identified cause of labral pathology in the hip. – Hospital for Special Surgery 2011

Abstract Labral tears typically occur anterosuperiorly in association with femoroacetabular impingement or dyspla- sia. Less commonly, labral pathology may occur in an atypical direct anterior location adjacent to the iliopsoas tendon in the absence of bony abnormalities. We hypothe- size that this pattern of injury is related to compression or traction on the anterior capsulo-labral complex by the iliopsoas tendon where it crosses the acetabular rim. In a retrospective review of prospectively collected data, we identi fi ed 25 patients that underwent isolated, primary, unilateral iliopsoas release and presented for at least 1 year follow-up (mean 21 months). Pre-operative demographics, clinical presentation, intra-operative fi ndings, and outcome questionnaires were analyzed. The injury was treated with a tenotomy of the iliopsoas tendon at the level of the joint line and either labral debridement or repair.

Mean post-operative outcome scores were 87.17, 92.46, and 78.8 for the modi fi ed Harris Hip Score, activities of daily living Hip Outcome Score, and sports-related score, respectively. The atypical labral injury identi fi ed in this study appears to represent a distinct pathological entity, psoas impingement, with an etiology which has not been previously described.

Keywords psoas impingement. hip arthroscopy. labral tears

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