title: Technique to treat iliopsoas irritation after total hip replacement: Thickening of articular hip capsule through an abridged direct anterior approach.
abstract: Iliopsoas irritation due to acetabular cup component impingement following total hip arthroplasty (THA) is usually treated by infiltration or by distal iliopsoas tenotomy in case of recurrence; however, this can result in an active flexion deficit of the thigh. To prevent this complication, we developed an original technique that we performed between 2012 and 2014 in patients with recurrent impingement following extraarticular corticosteroid injections. This included 5 patients (mean age: 64 [53-75] years old) in whom we performed an ambulatory bursectomy by the Hueter approach and placed a polyglactin 910 (Vicryl™) mesh plate on the entire anterior hip capsule. After a mean follow-up of 12months (9-29months), anterior pain had decreased in all patients with improvement and an increase in the Oxford-12 (mean: 15 points [10-19]), Merle d'Aubigné (mean: 2.5 points [1-5]) and Harris (mean: 18 points [10-29]) scores. No flexion deficits were observed. An infected postoperative hematoma had to be drained but was cured at follow-up. This simple procedure provides satisfactory results and preserves THA function. It does not jeopardize future procedures and is an alternative option in case of unsuccessful conservative treatment.
authors.affiliation: Université de Lille Nord de France, 59000 Lille, France; Service d'Orthopédie, Hôpital Salengro, CHRU de Lille, Place de Verdun, 59037 Lille cedex, France.
authors.forename: K
authors.initials: K
authors.lastname: Benad
authors.affiliation: Université de Lille Nord de France, 59000 Lille, France; Service d'Orthopédie, Hôpital Salengro, CHRU de Lille, Place de Verdun, 59037 Lille cedex, France; Laboratoire d'Anatomie et d'Organogenèse, Faculté de Médecine, Place de Verdun, 59045 Lille, France. Electronic address: delaycyril@gmail.com.
authors.forename: C
authors.initials: C
authors.lastname: Delay
authors.affiliation: Université de Lille Nord de France, 59000 Lille, France; Service d'Orthopédie, Hôpital Salengro, CHRU de Lille, Place de Verdun, 59037 Lille cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Putman
authors.affiliation: Université de Lille Nord de France, 59000 Lille, France; Service d'Orthopédie, Hôpital Salengro, CHRU de Lille, Place de Verdun, 59037 Lille cedex, France.
authors.forename: J
authors.initials: J
authors.lastname: Girard
authors.affiliation: Université de Lille Nord de France, 59000 Lille, France; Service d'Orthopédie, Hôpital Salengro, CHRU de Lille, Place de Verdun, 59037 Lille cedex, France.
authors.forename: G
authors.initials: G
authors.lastname: Pasquier
authors.affiliation: Université de Lille Nord de France, 59000 Lille, France; Service d'Orthopédie, Hôpital Salengro, CHRU de Lille, Place de Verdun, 59037 Lille cedex, France.
authors.forename: H
authors.initials: H
authors.lastname: Migaud
mesh_terms: D000077:Acetabulum / Q000601:surgery; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D002061:Bursa, Synovial / Q000601:surgery; D005260:Female; D006621:Hip Joint / Q000601:surgery*; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D017746:Joint Capsule / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D016059:Range of Motion, Articular; D012008:Recurrence; D012187:Retroperitoneal Space; D013526:Surgical Mesh; D052256:Tendinopathy / Q000209:etiology / Q000601:surgery*; D013848:Thigh
keywords: Complication; Iliopsoas impingement; Thickening of hip capsule; Total hip arthroplasty