Department of Physical Medicine and Rehabilitation, Mayo Clinic Health System, Mankato, MN.
Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine and Science, Rochester, MN.
PM R. 2021 Apr;13(4):397-404. doi: 10.1002/pmrj.12430. Epub 2020 Aug 20.
The iliopsoas is a common source of anterior hip pain. Refractory cases may require surgical intervention, with reported complication rates ranging from 3% to 50%. Development of a minimally invasive, outpatient method of iliopsoas tendon release is desirable and may reduce costs, lower complications, and improve recovery time.
To describe and evaluate the safety and reproducibility of an ultrasound-guided (USG) iliopsoas tendon release using a spinal needle in a cadaveric model.
Prospective, cadaveric laboratory investigation.
Academic Institution Procedural Skills Laboratory.
Five unembalmed cadaveric specimens (three female, two male), 69 to 93 years of age (mean 83.2 years), with a mean body mass index (BMI) of 24.5 kg/m (range 19.2 to 30.3 kg/m ).
Two operators each performed five USG iliopsoas tendon releases. Three additional investigators dissected the pelves to assess completeness of tendon release and damage to adjacent structures.
Successful transection, completeness (%) of the tendon transection, damage to adjacent structures, and procedural time.
Nine of 10 releases achieved the target release of ≥75% tendon transection. One procedure achieved 50% tendon release. No injury to adjacent structures was identified. The mean duration of the procedure was 6.19 minutes.
USG iliopsoas tendon release can be performed in a cadaveric model, consistently achieve the desired percentage of tendon release, does not result in injury to adjacent neurovascular structures, and takes approximately 6 minutes to perform. Although results cannot be generalized to a clinical setting, due to the minimally invasive nature of the procedure, it is likely that this procedure can be performed safely in an outpatient setting under local anesthesia, will cost less, and will facilitate a more rapid recovery when compared to standard surgical procedures. Further research is warranted for clinical application.
髂腰肌是导致髋关节前侧疼痛的常见原因。对于难治性病例，可能需要手术干预，其报告的并发症发生率为 3%至 50%。开发一种微创、门诊的髂腰肌肌腱松解术方法是理想的，这可能会降低成本、减少并发症并缩短康复时间。
描述并评估在尸体模型中使用脊柱针进行超声引导（USG）髂腰肌肌腱松解术的安全性和可重复性。
前瞻性尸体实验室研究。
学术机构程序技能实验室。
五具未防腐的尸体标本（三女两男），年龄 69 至 93 岁（平均 83.2 岁），平均体重指数（BMI）为 24.5 kg/m²（范围 19.2 至 30.3 kg/m²）。
两名操作员每人进行五次 USG 髂腰肌肌腱松解术。另外三名调查员解剖骨盆，以评估肌腱松解的完整性和对邻近结构的损伤。
成功横断、肌腱横断的完整性（%）、邻近结构损伤和手术时间。
10 次松解中有 9 次达到了目标释放，即≥75%的肌腱横断。一次手术实现了 50%的肌腱松解。未发现邻近结构损伤。手术平均持续时间为 6.19 分钟。
USG 髂腰肌肌腱松解术可在尸体模型中进行，可始终如一地实现所需的肌腱松解百分比，不会对邻近的神经血管结构造成损伤，且手术时间约为 6 分钟。尽管由于该手术的微创性质，无法将结果推广到临床环境，但与标准手术程序相比，该手术很可能可以在局部麻醉下安全地在门诊环境中进行，成本更低，并且更有利于快速康复。需要进一步的研究来进行临床应用。
