Iliopsoas Impingement: A Newly Identified Cause of Labral Pathology in the Hip |
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Authors: | Benjamin G Domb MD Michael K Shindle MD Benjamin McArthur MD James E Voos MD Erin M Magennis BA Bryan T Kelly MD |
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Institution: | (1) Department of Orthopedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA;(2) Hinsdale Orthopedics, 1010 Executive Court, Suite 250,, Westmont, IL 60559, USA;(3) Summit Medical Group, 1 Diamond Hill Road, Berkely Heights, NJ 07922, USA; |
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Abstract: | Labral tears typically occur anterosuperiorly in association with femoroacetabular impingement or dysplasia. Less commonly,
labral pathology may occur in an atypical direct anterior location adjacent to the iliopsoas tendon in the absence of bony
abnormalities. We hypothesize 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 identified 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 findings, 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 modified Harris
Hip Score, activities of daily living Hip Outcome Score, and sports-related score, respectively. The atypical labral injury
identified in this study appears to represent a distinct pathological entity, psoas impingement, with an etiology which has
not been previously described. |
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Keywords: | psoas impingement hip arthroscopy labral tears |
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