Risk factors and progress in diagnosis and treatment of iliopsoas impingement after total hip replacement
10.3760/cma.j.cn121113-20240617-00351
- VernacularTitle:全髋关节置换术后髂腰肌撞击的危险因素及诊疗进展
- Author:
Hongxun ZHU
1
;
Jijuan LYU
1
;
Peng ZHANG
1
;
Zhi FENG
1
;
Qinghe YE
1
Author Information
1. 山东省临沂市人民医院骨科，临沂 276000
- Publication Type:Journal Article
- Keywords:
Arthroplasty, replacement, hip;
Risk factors;
Review;
Iliopsoas impingement
- From:
Chinese Journal of Orthopaedics
2024;44(23):1567-1572
- CountryChina
- Language:Chinese
-
Abstract:
Total hip arthroplasty (THA) is a progressively refined orthopaedic surgery with excellent long-term survival rates, but it still faces problems such as postoperative pain, infection and loosening, especially groin pain. Iliopsoas impingement (IPI) is a relatively rare and overlooked cause of groin pain after THA, which often leads to delayed diagnosis and inappropriate treatment due to lack of awareness. IPI refers to the pain in the groin area caused by abnormal contact between the iliopsoas and the front of the acetabulum. There are many risk factors for IPI after THA including acetabular cup protrusion, osteophyte impingement, screw protrusion, bone cement extravasation, improper placement of acetabular prosthesis, and changes in lower limb length. The diagnosis of IPI is primarily based on physical examination, imaging findings, and a diagnostic treatment of pain relief following fluoroscopic or ultrasound-guided injection of corticosteroids and local anesthesia into the iliopsoas tendon sheath. Other potential causes such as hip dislocation, periprosthetic infection, loosening or fracture should be excluded. Treatment of IPI includes non-surgical treatment (non-steroidal anti-inflammatory drugs, physical therapy and ultrasound-guided injections of corticosteroids and local anesthesia in the iliopsoas tendon sheath), iliopsoas tenotomy, and acetabular cup revision, all three of which should be performed stepwise to maximize patient benefit.
