Division of Sports Medicine, Department of Orthopedic Surgery and Rehabilitation Medicine, University of Wisconsin, Madison, Wisconsin, U.S.A.
Division of Sports Medicine, Department of Orthopedic Surgery and Rehabilitation Medicine, University of Wisconsin, Madison, Wisconsin, U.S.A..
Arthroscopy. 2014 Jun;30(6):688-94. doi: 10.1016/j.arthro.2014.02.027. Epub 2014 Apr 3.
To document the clinical results of arthroscopic iliopsoas tenotomies performed at the level of the labrum to treat labral injuries caused by iliopsoas impingement.
From a review of the database of the senior author (J.S.K.) of 300 hip arthroscopies that were performed between September 2009 and May 2011, 30 patients who had an arthroscopic release of the iliopsoas tendon at the level of the labrum and at least 2 years' follow-up were identified. In all cases the release was performed to treat a tight psoas tendon that was found at arthroscopy to be impinging on a torn or inflamed labrum. The results of hip arthroscopy in these patients were assessed with Byrd's 100-point modified Harris Hip Score system before arthroscopy and at 3, 6, 12, and 24 months after surgery.
The mean age of the 30 patients was 35 years, and their preoperative scores averaged 43 points. After surgery, the patients had 6-month scores that averaged 73 points and 12-month scores that averaged 84 points (range, 40 to 100 points). Over the first postoperative year, in 3 of the 5 patients whose preoperative ultrasound imaging showed snapping of the tendon, recurrent painful snapping developed in the hip. All 3 had iliopsoas bursa injections and had immediate relief of their hip pain. In 2 patients the relief was temporary and an arthroscopic release of the tendon at the lesser trochanter was performed. The 2-year scores of the remaining 28 patients who did not have a second iliopsoas tenotomy averaged 88 points, and 23 of these patients had good or excellent results (scores ≥80 points).
An arthroscopic release of the iliopsoas tendon at the level of the labrum was effective for alleviating hip pain from labral lesions caused by impingement of the tendon in 23 of 30 patients (77%). The remaining 7 patients had persistent hip pain and hip scores lower than 80 points because of recurrent snapping of the tendon (3), development of avascular necrosis (1), progression of degenerative joint disease (1), or chronic greater trochanteric bursitis (2).
Level IV, therapeutic case series.
记录在盂唇水平行关节镜髂腰肌切断术治疗髂腰肌撞击引起的盂唇损伤的临床结果。
对 2009 年 9 月至 2011 年 5 月间进行的 300 例髋关节镜手术的数据库进行回顾，其中 30 例患者在盂唇水平行髂腰肌腱松解术，且至少随访 2 年。所有病例的释放均是为了治疗在关节镜下发现的紧髂腰肌肌腱，该肌腱撞击撕裂或炎症盂唇。这些患者的髋关节镜检查结果采用 Byrd 100 分改良 Harris 髋关节评分系统进行评估，包括术前、术后 3、6、12 和 24 个月。
30 例患者的平均年龄为 35 岁，术前平均评分为 43 分。术后 6 个月平均评分为 73 分，12 个月平均评分为 84 分（范围 40 至 100 分）。在术后 1 年内，术前超声检查显示肌腱弹响的 5 例患者中有 3 例出现髋关节疼痛复发。所有 3 例均接受了髂腰肌滑囊注射，髋关节疼痛立即缓解。2 例患者的缓解是暂时的，然后在小转子处行髂腰肌肌腱松解术。其余 28 例未行第二次髂腰肌切断术的患者 2 年的评分平均为 88 分，其中 23 例患者的结果为良好或优秀（评分≥80 分）。
在 30 例患者中，有 23 例（77%）通过在盂唇水平行髂腰肌肌腱松解术有效缓解了由肌腱撞击引起的盂唇病变引起的髋关节疼痛。其余 7 例患者因肌腱反复弹响（3 例）、发生股骨头缺血性坏死（1 例）、退行性关节病进展（1 例）或慢性大转子滑囊炎（2 例），髋关节疼痛持续存在，髋关节评分低于 80 分。
IV 级，治疗性病例系列研究。
