York, ME (207) 363 3490 | Portsmouth, NH (603) 431 1121

20Hip Care
10Hip-Conditions and Injuries
Cartilage Injury
Femoroacetabular Impingement (FAI)
Gluteal Tears
Hamstring Tears
Hip Instability
Deep Gluteal Space Syndrome
Labral Tears
Psoas Impingement (Internal Snapping Hip)
PVNS
Trochanteric Bursitis
10Hip-Treatment and Surgeries
Acetabuloplasty
Chondroplasty
Femoroplasty
Gluteal Repair
Labral Debridement
Labral Reconstruction
Labral Repair
Nanofracture
Psoas Release
Trochanteric Bursa Debridement
33Knee Care
13Knee Conditions and Injuries
ACL Tear
Cartilage Injury
Discoid Meniscus
Lateral Meniscus Tear
LCL Injury
MCL Injury
Medial Meniscus Tear
Osteoarthritis
Osteochondritis Dessicans
Patellar Instability
Patellofemoral Chondromalacia
Posterolateral Corner Injury
Trochlear Dysplasia
20Knee Treatment and Surgeries
Anterior Cruciate Ligament (ACL) Reconstruction
Cartilage Restoration Surgery – Autologous Chondrocyte Implantation (ACI-Carticel)
Cartilage Restoration Surgery – Donor Graft
Collagen Meniscal Implant (CMI)
Lateral Collateral Ligament (LCL) Reconstruction
Medial Collateral Ligament (MCL) Reconstruction
Meniscus Repair
Meniscus Root Repair
Meniscal Transplant
Medial Patellofemoral Ligament (MPFL) Reconstruction
Nanofracture
Osteochondral Allograft Transfer
Osteochondral Autograft Transfer (OATS)
Partial Knee Replacement (MAKO)
Partial Meniscectomy
Posterior Cruciate Ligament (PCL) Reconstruction
Posterolateral Corner (PLC) Surgery
Tibial Tubercle Osteotomy
Total Knee Replacement (MAKO)
Trochleoplasty
20Shoulder Care
10Shoulder-Conditions and Injuries
AC Joint Injuries
Arthritis
Biceps Tendon Injuries
Calcific Tendinitis
Clavicle Fractures
Frozen Shoulder
Labral and SLAP Tears
Rotator Cuff Injuries
Shoulder Dislocation/Instability
Subacromial Impingement/Busitis
10Shoulder-Treatment and Surgeries
A-C Joint Stabilization
Biceps Tenodesis
Clavicle Fracture Fixation
Pectoralis Major Repair
Rotator Cuff Repair
Shoulder Instability Surgery – Bankart Repair
Shoulder Instability Surgery – Latarjet Procedure
Subacromial Decompression and Acromioplasty
Superior Capsular Reconstruction
Total Shoulder Replacement

PSOAS RELEASE

The iliopsoas is a muscle-tendon unit that plays an important role in hip flexion, and is therefore considered a “hip flexor.” The psoas tendon crosses over the top of the hip joint and inserts on to the femur bone. In some individuals, the psoas can become very tight and irritated, particularly in patients who are active in sports or in patients with hip impingement (FAI). The psoas tendon can also rub against the hip joint abnormally, causing internal snapping hip syndrome. In patients who fail non-operative management for psoas irritation, tearing, or snapping hip syndrome, surgery may be recommended.

During surgery, Dr. Welch maneuvers a camera and surgical instruments through small incisions into the hip joint. Dr. Welch identifies the iliopsoas tendon with a camera. The iliopsoas usually appears inflamed and/or partially torn near its insertion on the femur bone. Dr. Welch then uses a sharp instrument to release the tight part of the tendon (lengthening procedure) and carefully cleans the frayed edges of the tendon. This process usually elongates the tendon enough to relieve the symptoms associated with the tendon rubbing over the front of the hip joint. Previous research has also demonstrated that lengthening of the tendon does not reduce the tendon’s strength.

Postoperative Rehabilitation

Following surgery, Dr. Welch recommends a guided physical therapy program with a licensed physical therapist. Early motion following surgery is very important, and Dr. Welch recommends that each patient either use a stationary bike or a continuous passive motion machine daily. Dr. Welch may also recommend the use of a brace for approximately two weeks to help protect the hip.