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Indefinite activity modification
2%
92/3899
Iliopsoas tendon release
74%
2899/3899
Femoral component revision
7%
261/3899
Acetabular component revision
15%
582/3899
Femoral and acetabular component revision
1%
45/3899
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After diagnosis of iliopsoas impingement, iliopsoas muscle tenotomy or resection is the treatment of choice if radiographs are within normal limits. In contrast, if imaging shows anterior acetabular overhang (as shown in Illustration A), then acetabular revision would be the next appropriate step in management. Lachiewicz et al provide a great review on iliopsoas impingement after THA. Anterior iliopsoas impingement can cause functional disability after total hip arthroplasty. The diagnosis may be confirmed by one or more imaging studies, including a cross-table lateral radiograph, computed tomography, magnetic resonance imaging, and ultrasonography, in combination with a confirmatory diagnostic injection into the iliopsoas sheath. Treatment, consisting of release or resection of the iliopsoas tendon, alone or in combination with acetabular revision for an anterior overhanging component, usually provides permanent pain relief. Trousdale et al also reviewed cases of iliopsoas impingment after THA. They studied two cases of iliopsoas tendinitis following THA due to a malpositioned, uncemented, metal-backed acetabular component. In cases of anterior acetabular overhang, acetabular revision to reduce anterior impingement is the appropriate management. Illustration A shows an example of anterior acetabular overhang which would require acetabular revision if symptomatic.
2.5
(36)
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