Document Detail


Case report: Bifid iliopsoas tendon causing refractory internal snapping hip.
MedLine Citation:
PMID:  20593254     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Treatment of painful internal snapping hip (coxa saltans) via arthroscopic lengthening or release of the iliopsoas tendon is becoming preferred over open techniques because of the benefits of minimal dissection, the ability to address concomitant intraarticular disorders, and a low complication rate. Persistent snapping after release is uncommon, especially when performed arthroscopically. Reported causes include incomplete release, intraarticular disorders, and incorrect diagnosis. Anatomic variants are not discussed in the orthopaedic literature. CASE DESCRIPTION: We report a case of an 18-year-old softball player with internal snapping hip treated with arthroscopic iliopsoas release in the peripheral compartment. Postoperatively, the athlete continued to have painful snapping. Repeat arthroscopy with a larger capsulotomy revealed a bifid iliopsoas tendon causing refractory internal snapping hip, which resolved after revision arthroscopic release. LITERATURE REVIEW: Bifid iliopsoas tendon as a cause of persistent snapping of the hip has not been reported in the orthopaedic literature. Prior sonographic and anatomic studies suggest the bifid iliopsoas tendon exists but is uncommon. PURPOSE AND CLINICAL RELEVANCE: Recognition that a bifid iliopsoas tendon may be the source of painful internal snapping hip is important to prevent clinical failure of surgical management of the internal snapping hip. The differential diagnosis of failed iliopsoas lengthening surgery should include the consideration of an incompletely lengthened tendon attributable to bifid iliopsoas tendon anatomy. Prevention of this complication includes making a large enough capsulotomy to identify the tendon and to ensure it is not bifid.
Authors:
Beatrice Shu; Marc R Safran
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Publication Detail:
Type:  Case Reports; Journal Article; Review     Date:  2010-07-01
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  469     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-24     Completed Date:  2011-01-25     Revised Date:  2012-01-02    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  289-93     Citation Subset:  AIM; IM    
Affiliation:
Department of Orthopaedic Surgery, Stanford University, 450 Broadway, M/C 6342, Redwood City, CA 94063, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Arthralgia / etiology*,  physiopathology,  surgery
Arthroscopy
Female
Hip Joint / physiopathology*,  surgery
Humans
Joint Diseases / etiology*,  physiopathology,  surgery
Noise
Pain, Postoperative / etiology,  surgery
Reoperation
Tendons / abnormalities*,  surgery
Tenotomy
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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