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Arthroscopic iliopsoas fractional lengthening may improve PROs for patients with FAI, labral tears
Patients with femoroacetabular impingement and labral tears who underwent arthroscopic iliopsoas fractional lengthening for treatment of painful internal snapping experienced good short- to mid-term follow-up results, as well as improvements in patient reported outcomes, according to results published in The American Journal of Sports Medicine.
Among 351 hips that underwent hip arthroscopy for both femoroacetabular impingement (FAI) and labral tear treatment with iliopsoas fractional lengthening for painful internal snapping, Benjamin G. Domb, MD, and colleagues calculated modified Harris Hip Score, International Hip Outcome Tool-12, Hip Outcome Score-Activity of Daily Living Score, Hip Outcome Score-Sports Specific Subscale, Non-Arthritis Hip Score, VAS for pain, patient satisfaction, minimal clinically important difference and the percentage of patients who achieved patient acceptable symptomatic state. They compared these scores with a control group of 392 hips that did not receive iliopsoas fractional lengthening. Researchers also documented revision surgeries and conversions to total hip arthroplasty.
Mean follow-up time was approximately 42.5 months and 43.9 months in the iliopsoas fractional lengthening group and the control group, respectively. At 2-year follow-up, results showed significant postoperative improvement in patient reported outcomes in both groups. Researchers noted comparable results for patient reported outcome (PRO) improvement, minimal clinically important difference, patient acceptable symptomatic state and rates of revision or THA conversion between the iliopsoas fractional lengthening group and the control group.
“With the meticulous technique we have described in this article, along with care to address coexisting pathology, including microinstability, this multicenter study demonstrated that iliopsoas fractional lengthening is a safe and effective procedure to address painful internal snapping hip,” Domb told Healio.com/Orthopedics. “However, this technique and the accompanying procedures are technically challenging, and should be performed at centers specializing in Hip Preservation whenever possible.” – by Casey Tingle
Disclosures: Domb reports he receives personal fees and other from Arthrex, Pacira and Stryker; personal fees from Orthomerica, DJO Global, Amplitude and Medacta; and is a board member for the American Hip Institute, at the Arthroscopy Association of North American Learning Center Committee and Arthroscopy Journal. Please see the full study for a list of all other authors’ relevant financial disclosures.