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.
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.