Thaunat Mathieu, Barbosa Nuno C, Clowez Gilles, Murphy Colin G, Bah Aliou, Kouevidjin Biova T, Sonnery-Cottet Bertrand
Ramsay Générale de Santé, Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, Lyon, France.
Arthrosc Tech. 2018 Mar 12;7(4):e349-e353. doi: 10.1016/j.eats.2017.10.003. eCollection 2018 Apr.
Arthroscopic release of the iliopsoas tendon for iliopsoas impingement (IPI) after total hip arthroplasty (THA) at the lesser trochanter gives good results. However, where IPI then recurs, due to adhesions between the healing iliopsoas tendon and the surrounding soft tissue, and nonoperative measures have failed, a revision THA procedure is usually considered. We propose a technique of arthroscopic visualization of the recurrent IPI and a subsequent psoas tenotomy at the level of the hip joint using an outside-in capsulotomy approach. This secondary tenotomy, located proximally directly at the level of the recurrent impingement, allows relief of the painful symptoms without compromising the muscle function of the iliopsoas and precludes the need for a complex THA revision.
全髋关节置换术（THA）后，在小转子处通过关节镜松解髂腰肌肌腱治疗髂腰肌撞击症（IPI）可取得良好效果。然而，如果IPI复发，是由于愈合的髂腰肌肌腱与周围软组织之间形成粘连，且非手术措施无效，通常会考虑进行THA翻修手术。我们提出一种技术，即通过关节镜观察复发性IPI，并采用由外向内的关节囊切开术方法在髋关节水平进行腰大肌肌腱切断术。这种二次肌腱切断术直接位于近端复发性撞击的水平，可缓解疼痛症状，同时不损害髂腰肌的肌肉功能，并且无需进行复杂的THA翻修。
