Hip: Intra-articular Arthroscopic Recession of the Iliopsoas Tendon: Medial Protection Technique (Downloadable)
Allston J. Stubbs, IV, MD, Winston-Salem, NC
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Area of Focus: Arthroscopy and Hip, Knee & Lower Extremity
Hip pain often accompanies iliopsoas pathology such as tendonitis/bursitis, contracture, and mechanical snapping. Pathologic iliopsoas conditions can occur with both native hip disease and hip arthroplasty. In the setting of chronic iliopsoas pathology, surgical management may be an option to alleviate symptoms and reduce mechanical stress across the lumbar spine, proximal femur, and anterosuperior acetabular rim. Surgical techniques are available to release or recess the iliopsoas muscle tendon unit at various anatomic locations. Traditionally, these approaches, both open and arthroscopic, have focused on release of the iliopsoas tendon from its insertion on the lesser trochanter. A more recent approach involves an arthroscopic release of the iliopsoas at the level of the hip joint, a release that is more proximal than the traditional one. Arthroscopic release at the level of the hip joint is technically demanding, and it poses a theoretical risk of iatrogenic injury to the femoral neurovascular structures, which is a significant complication. The two primary modes of intra-articular arthroscopic iliopsoas release or recession involve tenotomy either from the peripheral compartment or from the central compartment. One such central- compartment technique is the medial protection technique, which protects the femoral neurovascular structures from iatrogenic injury. This video details the medial protection technique with a two-portal hip arthroscopy method. We present a complete surgical case and a discussion of the technical pearls and pitfalls.
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- Hip: Intra-articular Arthroscopic Recession of the Iliopsoas Tendon: Medial Protection Technique (V11044)
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