Medium-term and long-term outcomes of interventions for primary psoas tendinopathy.

OBJECTIVE

To assess medium- and long-term outcomes of psoas tendinopathy to psoas tenotomy and image-guided steroid injections.

DESIGN

This is a 14-year retrospective case-control study to identify the efficacy of psoas tenotomy and image-guided steroid injections.

SETTING

This study was undertaken in a secondary care setting.

PATIENTS

Patients with confirmed psoas tendinopathy were followed up by postal questionnaire, which included a nonarthritic hip score (NAHS) and a study patient satisfaction questionnaire.

INTERVENTIONS

Patients underwent image-guided steroid injections. Depending on the analgesic or symptomatic relief, some patients proceeded to psoas tenotomy.

MAIN OUTCOME MEASURES

Response to steroid injection. Pain relief and symptomatic relief after the surgery.

RESULTS

Twenty-three patients were reviewed with a 70% follow-up over a time of 49 months for surgery (range, 13-144 months) and 77 months for injection (range, 14-160 months). Eight patients had a lasting response to injection and required no further intervention, and 15 patients proceeded to psoas tenotomy using a medial Ludloff approach. The average NAHS scores after the surgery and injection were 66.15 and 76.08, respectively. Ten patients reported pain relief after their tenotomy, and 5 patients reported no change in pain. All 8 patients, who only underwent injection, reported lasting pain relief.

CONCLUSIONS

Local steroid injections can provide long-term relief for patients presenting with psoas tendinopathy. For those patients with only temporary relief from injection, psoas tenotomy can provide good long-term pain relief.