چکیده (انگلیسی):

Introduction: Iliopsoas tendinitis after revision total hip arthroplasty (THA) is rare and its etiology and
optimal treatment are still unclear. We report a case of iliopsoas impingement after revision THA with a
Kerboull acetabular reinforcement device requiring two-level iliopsoas muscle transection.
Presentation of case: A 70-year-old woman presented to our hospital complaining of debilitating right
groin pain after revision THA with a Kerboull reinforcement device. She had undergone multiple hip
operations after experiencing a pelvic fracture in a motor vehicle accident. A lidocaine nerve block at the
level of the Kerboull device resulted in temporary but marked reduction in pain and a diagnosis of psoas
impingent. We performed surgery via an anterior approach to release the iliopsoas muscle from the
lesser trochanter. After iliopsoas tenotomy was performed, the muscle was still under high tension
because of dense adhesions. Repeat transection of the iliopsoas muscle at the level of the anterior branch
of the Kerboull device resulted in loosening of the iliopsoas muscle and resolution of impingement.
Postoperatively, the patient's groin pain completely disappeared, and she can now walk with a single
cane and is satisfied with her result.
Discussion: Adhesions around the iliopsoas muscle likely contributed to the patient's groin pain. Open
surgery to perform complete release of iliopsoas muscle impingement should be considered in patients
with pain after revision THA.
Conclusion: We reported a patient with Iliopsoas tendinitis after revision THA requiring two-level
iliopsoas muscle transection.