# Arthroscopic Iliopsoas Lengthening Is a Safe and Effective Treatment for Anterior Iliopsoas Impingement After Total Hip Arthroplasty

## TL;DR

Arthroscopic iliopsoas lengthening is a safe and effective treatment for anterior iliopsoas impingement after total hip arthroplasty, providing pain relief and avoiding major surgery.

## Contribution

Demonstrates the safety and effectiveness of arthroscopic iliopsoas lengthening for treating anterior iliopsoas impingement after total hip arthroplasty.

## Key findings

- 80% of patients were pain-free at follow-up with a median of 3.8 years.
- No THA revisions, reoperations, or infections occurred after the procedure.
- Pain scores decreased significantly from preoperative to postoperative.

## Abstract

To assess the demographic characteristics, preoperative variables, and postoperative outcomes of patients who underwent arthroscopic iliopsoas lengthening for anterior iliopsoas impingement (AII) after total hip arthroplasty (THA).

A retrospective, single-surgeon case series was conducted to identify patients with AII after THA who underwent arthroscopic iliopsoas lengthening between 2017 and 2024. A minimum 1-year follow-up after arthroscopic procedures was required for patients to be included in this study. All arthroscopic procedures were completed by a single orthopaedic sports fellowship-trained surgeon. The primary outcomes were the incidence of THA revision, incidence of reoperations and secondary surgical procedures, and changes in pain scores.

Of 15 hips, 12 (80%) were reported to be pain free at most recent follow-up (median follow-up, 3.8 years [range, 1.3-6.8 years]). There were no THA revisions performed after arthroscopy, no reoperations or secondary surgical procedures, and no infections requiring surgical intervention. The median pain score decreased from 8 preoperatively (interquartile range, 6.5-10; range, 3-10) to 0 postoperatively (interquartile range, 0-1; range, 0-5) (P < .001). For the index THA, a posterior approach was used in 7 patients (47%) whereas an anterior approach was used in 8 (53%).

Arthroscopic iliopsoas lengthening is a safe and effective treatment for AII after THA. The procedure had minimal complications, provided considerable pain relief in 80% of patients, and helped avoid major revision arthroplasty surgery in 100% of cases.

Level IV, retrospective therapeutic case series.