The iliopsoas muscle passes through the hip and inserts into the upper thigh bone. It helps flex the hip joint and is necessary for standing, making postural changes, walking and running. The tendon of this muscle passes near the head of the femur (thigh bone) in the region of a bony projection called the iliopectineal eminence. During hip flexion and extension, the iliopsoas can sometimes produce a snapping sensation or sound by rubbing against this projection. It can occur while getting up from a chair or walking up steps and may be accompanied by groin pain and difficulty walking. The iliopsoas may also be tight or become impinged and can damage parts of the hip joint.
Your doctor will examine your hip carefully and perform certain maneuvers to reproduce the snapping phenomenon. Imaging studies help visualize the iliopsoas and identify problems with the hip joint. An anesthetic injection can help identify the iliopsoas as the source of pain. If conservative treatments such as rest, pain medications and physical therapy do not resolve the issue, surgical release of the iliopsoas may be recommended.
Iliopsoas release can be performed through a minimally invasive arthroscopic procedure. You will lie on your back or side and under anesthesia small incisions are made over the front and side of the hip and portals are created to access the iliopsoas. The arthroscope is inserted into one of the portals to visualize the area and special instruments introduced to carry out the procedure. In case of impingement, your doctor will repair any damaged tissue or clear any areas of bony impaction. The iliopsoas may be accessed through the capsule of the hip joint or near its insertion at the thigh bone. A certain volume of the muscle or tendon is cut to perform the release.
As with any procedure, iliopsoas release may be associated with certain complications such as heterotopic bone formation (abnormal bone growth in the soft tissues) or recurrence due to incomplete release, untreated bony abnormalities or the presence of a split or bifid tendon.