Medium-term and long-term outcomes of interventions for primary psoas tendinopathy.

Abstract

OBJECTIVE:

To assess medium- and long-term outcomes of psoas tendinopathy to psoas tenotomy and image-guided steroid injections.

DESIGN:

This is a 14-year retrospective case-control study to identify the efficacy of psoas tenotomy and image-guided steroid injections.

SETTING:

This study was undertaken in a secondary care setting.

PATIENTS:

Patients with confirmed psoas tendinopathy were followed up by postal questionnaire, which included a nonarthritic hip score (NAHS) and a study patient satisfaction questionnaire.

INTERVENTIONS:

Patients underwent image-guided steroid injections. Depending on the analgesic or symptomatic relief, some patients proceeded to psoas tenotomy.

MAIN OUTCOME MEASURES:

Response to steroid injection. Pain relief and symptomatic relief after the surgery.

RESULTS:

Twenty-three patients were reviewed with a 70% follow-up over a time of 49 months for surgery (range, 13-144 months) and 77 months for injection (range, 14-160 months). Eight patients had a lasting response to injection and required no further intervention, and 15 patients proceeded to psoas tenotomy using a medial Ludloff approach. The average NAHS scores after the surgery and injection were 66.15 and 76.08, respectively. Ten patients reported pain relief after their tenotomy, and 5 patients reported no change in pain. All 8 patients, who only underwent injection, reported lasting pain relief.

CONCLUSIONS:

Local steroid injections can provide long-term relief for patients presenting with psoas tendinopathy. For those patients with only temporary relief from injection, psoas tenotomy can provide good long-term pain relief.

• Authors: Kanai Garala, Vishnu Prasad, Kanagaratnam Jeyapalan, Richard A Power
• Journal: Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine (Clin J Sport Med) Vol. 24 Issue 3 Pg. 205-10 (May 2014) ISSN: 1536-3724 [Electronic] United States
• PMID: 24284952 (Publication Type: Journal Article)

Chemical References

• Anesthetics, Local
• Anti-Inflammatory Agents
• Triamcinolone

Topics

• Adult
• Aged
• Aged, 80 and over
• Anesthetics, Local (administration & dosage)
• Anti-Inflammatory Agents (administration & dosage)
• Case-Control Studies
• Female
• Follow-Up Studies
• Hip Joint
• Humans
• Injections, Intra-Articular
• Male
• Middle Aged
• Musculoskeletal Pain (drug therapy, etiology, surgery)
• Pain Measurement
• Psoas Muscles
• Retrospective Studies
• Surveys and Questionnaires
• Tendinopathy (complications, drug therapy, surgery)
• Tenotomy
• Time Factors
• Treatment Outcome
• Triamcinolone (administration & dosage)