Arthroscopic treatment of iliopsoas tendinitis after total hip arthroplasty with acetabular cup malposition: Two case reports
| Autor: | Shin-Yoon Kim, Seung-Hoon Baek, Kwang-Hwan Kim, Heejae Won, Jae-Wook Jung |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
musculoskeletal diseases
medicine.medical_specialty medicine.medical_treatment Tenotomy Arthroscopy 03 medical and health sciences 0302 clinical medicine Tendinitis parasitic diseases Case report medicine medicine.diagnostic_test business.industry General Medicine Iliopsoas tendinitis equipment and supplies musculoskeletal system medicine.disease Surgery Cup malposition surgical procedures operative 030220 oncology & carcinogenesis Total hip arthroplasty 030211 gastroenterology & hepatology Iliopsoas business |
| Zdroj: | World Journal of Clinical Cases |
| ISSN: | 2307-8960 |
| DOI: | 10.12998/wjcc.v8.i21.5326 |
| Popis: | BACKGROUND Optimal treatment for iliopsoas tendinitis after total hip arthroplasty (THA) with cup malposition, iliopsoas release alone or with cup revision, is controversial, particularly in young, active patients. Moreover, arthroscopic iliopsoas tendon (IPT) release in these patients has been rarely described, and midterm effects of this procedure on THA longevity and groin pain recurrence remain unclear. We performed arthroscopic IPT release after THA and report midterm outcomes in two young patients with acetabular cup malposition. CASE SUMMARY In the two patients, groin pain started early after THA. Physical examination revealed nonspecific findings, and laboratory tests showed no evidence of infection. Radiography and computed tomography showed reduced acetabular component anteversion angle and anterior cup prominence of more than 16 mm. For therapeutic diagnosis, ultrasonography-guided lidocaine with steroid was injected into the IPT sheath. In both patients, groin pain improved initially but worsened after a few months. Therefore, the patients underwent arthroscopic IPT release under spinal anesthesia. Arthroscopy revealed synovitis with fibrous tissues around the IPT and various lesions related to the implants after THA. IPT tenotomy and debridement with biopsy were performed; histopathologic studies showed chronic inflammation with synovial hyperplasia. Both patients were encouraged to start walking immediately after surgery, and they returned to complete daily function early after surgery. They experienced no recurrence of groin pain or any implant-related problems 5 years postoperatively. CONCLUSION Arthroscopic IPT release for cup malposition produced excellent midterm outcomes without recurrence of groin pain and implant-related problems. |
| Databáze: | OpenAIRE |
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