Baur Alexander, Lemons Wesley, Satalich James, Vap Alexander, O'Connell Robert
2nd year Medical Student, Liberty University College of Osteopathic Medicine, Lynchburg, VA 24502, USA.
PGY-1, Virginia Commonwealth University School of Medicine, Richmond, VA 23298, USA.
J Hip Preserv Surg. 2023 Nov 15;11(1):67-79. doi: 10.1093/jhps/hnad039. eCollection 2024 Jan.
Arthroscopic iliopsoas fractional lengthening (IFL) is a surgical option for the treatment of internal snapping hip syndrome (ISHS) after failing conservative management. Systematic review. A search of PubMed central, National Library of Medicine (MEDLINE) and Scopus databases were performed by two individuals from the date of inception to April 2023. Inclusion criteria were ISHS treated with arthroscopy. Sample size, patient-reported outcomes and complications were recorded for 24 selected papers. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed and registered on PROSPERO database for systematic reviews (CRD42023427466). Thirteen retrospective case series, ten retrospective comparative studies, and one randomized control trial from 2005 to 2022 were reported on 1021 patients who received an iliopsoas fractional lengthening. The extracted data included patient satisfaction, visual analogue scale, the modified Harris hip score and additional outcome measures. All 24 papers reported statistically significant improvements in post-operative patient-reported outcome measures after primary hip arthroscopy and iliopsoas fractional lengthening. However, none of the comparative studies found a statistical benefit in performing IFL. Existing studies lack conclusive evidence on the benefits of Iliopsoas Fractional Lengthening (IFL), especially for competitive athletes, individuals with Femoroacetabular Impingement (FAI), and borderline hip dysplasia. Some research suggests IFL may be a safe addition to hip arthroscopy for Internal Snapping Hip Syndrome, but more comprehensive investigations are needed. Future studies should distinguish between concurrent procedures and develop methods to determine if the psoas muscle is the source of pain, instead of solely attributing it to the joint.
关节镜下髂腰肌部分延长术（IFL）是保守治疗失败后治疗髋关节内弹响综合征（ISHS）的一种手术选择。系统评价。两名研究人员从数据库建立之日至2023年4月对美国国立医学图书馆（MEDLINE）的PubMed中心数据库和Scopus数据库进行了检索。纳入标准为接受关节镜治疗的ISHS。记录了24篇选定论文的样本量、患者报告的结局和并发症。遵循系统评价和Meta分析的首选报告项目指南，并在PROSPERO系统评价数据库（CRD42023427466）中进行了注册。报告了2005年至2022年的13个回顾性病例系列、10个回顾性对照研究和1个随机对照试验，涉及1021例接受髂腰肌部分延长术的患者。提取的数据包括患者满意度、视觉模拟量表、改良Harris髋关节评分和其他结局指标。所有24篇论文均报告，在初次髋关节镜检查和髂腰肌部分延长术后，患者报告的结局指标有统计学意义的改善。然而，没有一项对照研究发现进行IFL有统计学益处。现有研究缺乏关于髂腰肌部分延长术（IFL）益处的确凿证据，尤其是对于竞技运动员、股骨髋臼撞击症（FAI）患者和临界髋关节发育不良患者。一些研究表明，IFL可能是髋关节镜治疗髋关节内弹响综合征的一种安全补充，但仍需要更全面的研究。未来的研究应区分同期手术，并开发方法来确定腰大肌是否为疼痛来源，而不是仅将其归因于关节。
