VCU Medical Center, Richmond, Virginia, U.S.A..
VCU Medical Center, Richmond, Virginia, U.S.A.
Arthroscopy. 2018 Apr;34(4):1332-1339. doi: 10.1016/j.arthro.2017.10.051. Epub 2018 Feb 1.
To conduct a systematic review of the literature comparing patient outcomes following arthroscopic and open operative management of iliopsoas tendonitis (IPT) following total hip replacement (THR).
This review study was conducted in accordance with the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) statement. Inclusion criteria were as follows: outcome studies following open or arthroscopic iliopsoas tendon release after THR with at least 6 months of follow-up, English language, and human studies. The exclusion criteria included case reports, articles evaluating nonsurgical management or cup revision, and articles without a specific diagnosis of IPT or in which results between open and arthroscopic treatment were reported in conjunction.
A total of 131 studies were initially retrieved, with 7 satisfying all inclusion criteria (4 studies on arthroscopic tenotomy and 3 studies on open tenotomy). The review included a total of 88 patients with IPT-61 patients treated arthroscopically and 27 patients treated with open tenotomy. In total, 77 of the 88 patients demonstrated successful outcomes following surgery. In the group treated with arthroscopy, 91.8% (56/61) of patients had successful outcomes, whereas in those treated with open tenotomy, 77.8% (21/27) of patients had successful outcomes. Of patients with signs of mechanical impingement from acetabular component overhang, those who underwent open tenotomy had complete pain relief in 6/8 patients (75%) compared to arthroscopic tenotomy in which there was relief in 40/43 patients (93%).
Arthroscopic iliopsoas release for management of IPT is suggested to be an effective minimally invasive operative technique that may also yield a lower complication rate in comparison to open tenotomy. Tenotomy, both arthroscopic and open, are successful treatment options for IPT, including those with signs of mechanical impingement, and are recommended prior to cup revision.
Level IV, systematic review of level IV studies.
对全髋关节置换（THR）后行关节镜和开放式手术治疗髂腰肌肌腱炎（IPT）的患者结局进行系统回顾。
本综述研究根据系统评价和荟萃分析的首选报告项目（PRISMA）声明进行。纳入标准如下：THR 后行开放式或关节镜下髂腰肌肌腱松解术，且随访时间至少 6 个月，为英文文献，为人类研究。排除标准包括病例报告、评估非手术治疗或杯修正的文章，以及未明确诊断为 IPT 或联合报告开放式和关节镜治疗结果的文章。
最初检索到 131 项研究，其中 7 项符合所有纳入标准（4 项关节镜肌腱切开术和 3 项开放式肌腱切开术）。该综述共纳入 88 例 IPT 患者-61 例接受关节镜下治疗，27 例接受开放式肌腱切开术。88 例患者中，77 例术后结局成功。在接受关节镜治疗的患者中，91.8%（56/61）的患者结局成功，而接受开放式肌腱切开术的患者中，77.8%（21/27）的患者结局成功。在存在髋臼组件突出引起机械撞击迹象的患者中，接受开放式肌腱切开术的 8 例患者中有 6 例（75%）完全缓解疼痛，而接受关节镜下肌腱切开术的 43 例患者中有 40 例（93%）缓解疼痛。
对于管理 IPT，关节镜下髂腰肌松解术被认为是一种有效的微创手术技术，与开放式肌腱切开术相比，可能具有更低的并发症发生率。肌腱切开术，无论是关节镜下还是开放式，都是 IPT 的有效治疗选择，包括有机械撞击迹象的患者，且推荐在进行杯修正之前采用。
IV 级，对 IV 级研究的系统评价。
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