Iliopsoas Injections: A Systematic Review of Patient Outcomes and Progression to Surgery.

IF 1.7 Q2 SURGERY JBJS Reviews Pub Date : 2025-01-15 eCollection Date: 2025-01-01 DOI:10.2106/JBJS.RVW.24.00162

Luca Katz, Griffin Feinberg, Victoria Kent, Matthew Quinn, John D Milner, Ramin Tabaddor

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Abstract

Background: Iliopsoas injuries are a common cause of anterior hip and groin pain and can be successfully managed with conservative treatment. Corticosteroid and local anesthetic injections can also be offered in conjunction with nonoperative management. Given the variability in reported injection guidelines, composition, and techniques, the purpose of this study was to systematically review the literature to assess progression to surgery and patient outcomes following iliopsoas injections.

Methods: Four online databases (PubMed, Cochrane Library, MEDLINE, and Scopus) were searched for studies investigating the outcomes of iliopsoas injections from database inception until January 2024 in accordance with the Preferred Reporting Items for Systematic Meta-Analyses guidelines. Three reviewers screened titles, abstracts, and full-text articles independently and in duplicate. Recorded data included demographic data, patient-reported outcomes, complications, injection traits, and progression to surgery.

Results: Six articles were included in the review (follow-up time = 28.6 months). These studies included patients with iliopsoas bursitis, tendinopathy, and snapping hip. Five studies used the iliopsoas bursa as the injection target. All studies used local anesthetics in their injection formulations, with 5 also adding a corticosteroid. In 3 studies, the Numeric Rating Scale improved from preinjection (mean = 7.33) to postinjection (mean = 2.47). Three studies demonstrated an improvement in Harris Hip Score from a mean of 58.49 preinjection to 89.91 postinjection. Following injections, 28.9% (68/235) of patients progressed to surgery, with psoas tenotomy (38.3%, 26/68) being the most common procedure. There were no complications reported in all of the included studies.

Conclusion: This study demonstrates that iliopsoas injections are a clinically effective treatment of a variety of pathologies, including bursitis, tendinopathy, and snapping hip, and have a low rate of complications. Physicians should consider using iliopsoas injections in patients whose symptoms are refractory to conservative management, including physical therapy.

Level of evidence: Level III. See Instructions for Authors for a complete description of levels of evidence.

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髂腰肌注射：对患者预后和手术进展的系统回顾。

背景：髂腰肌损伤是髋前部和腹股沟疼痛的常见原因，可以通过保守治疗成功地控制。皮质类固醇和局部麻醉注射也可以与非手术治疗相结合。考虑到报道的注射指南、成分和技术的差异，本研究的目的是系统地回顾文献，以评估髂腰肌注射后的手术进展和患者预后。方法：根据系统荟萃分析指南的首选报告项目，检索四个在线数据库（PubMed, Cochrane Library， MEDLINE和Scopus），从数据库建立到2024年1月，调查髂腰肌注射结果的研究。三位审稿人独立并一式两份地筛选标题、摘要和全文文章。记录的数据包括人口统计数据、患者报告的结果、并发症、注射特征和手术进展。结果：共纳入6篇文献，随访时间28.6个月。这些研究包括髂腰肌滑囊炎、肌腱病和髋裂的患者。五项研究以髂腰肌滑囊为注射靶点。所有研究都在注射配方中使用局部麻醉剂，其中5项研究还添加了皮质类固醇。在3项研究中，数值评定量表从注射前（平均= 7.33）改善到注射后（平均= 2.47）。三项研究表明Harris髋关节评分从注射前的平均58.49分提高到注射后的平均89.91分。注射后，28.9%（68/235）的患者进行手术，其中腰肌肌腱切断术（38.3%,26/68）是最常见的手术。所有纳入的研究均未发现并发症。结论：本研究表明髂腰肌注射是一种临床有效的治疗多种疾病的方法，包括滑囊炎、肌腱病和髋关节折断，并且并发症发生率低。医生应考虑使用髂腰肌注射患者的症状难以保守管理，包括物理治疗。证据等级：三级。有关证据水平的完整描述，请参见作者说明。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JBJS Reviews SURGERY-

CiteScore

4.40

自引率

4.30%

发文量

132

期刊介绍： JBJS Reviews is an innovative review journal from the publishers of The Journal of Bone & Joint Surgery. This continuously published online journal provides comprehensive, objective, and authoritative review articles written by recognized experts in the field. Edited by Thomas A. Einhorn, MD, and a distinguished Editorial Board, each issue of JBJS Reviews, updates the orthopaedic community on important topics in a concise, time-saving manner, providing expert insights into orthopaedic research and clinical experience. Comprehensive reviews, special features, and integrated CME provide orthopaedic surgeons with valuable perspectives on surgical practice and the latest advances in the field within twelve subspecialty areas: Basic Science, Education & Training, Elbow, Ethics, Foot & Ankle, Hand & Wrist, Hip, Infection, Knee, Oncology, Pediatrics, Pain Management, Rehabilitation, Shoulder, Spine, Sports Medicine, Trauma.