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Minimum 5-year follow-up of arthroscopic treatment of symptomatic iliopectineal cyst

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Abstract

Introduction

We aimed to primarily assess the clinical and functional outcomes of arthroscopic treatment of the symptomatic iliopectineal cyst at a minimum 5-year follow-up. Our secondary objective was to document the technical nuances of our arthroscopic technique.

Methods

A retrospective review of chart data was performed for 30 patients who underwent arthroscopic treatment of a symptomatic iliopectineal cyst in the period between 1999 and 2015. The mean age of our patients was 57 (33–78) years. All patients completed a minimum follow-up period of 5 years. Our clinical outcomes were assessed by 100 mm VAS for pain, recurrence rate and complications. Functional outcome was evaluated by the modified Harris hip score (mHHS). Patients were asked their level of satisfaction with surgery on a scale of 0–10.

Results

In all patients, the valve mechanism of the iliopectineal cyst could be released arthroscopically and the cyst could be completely evacuated. The preoperative symptoms disappeared within 3–6 weeks after the arthroscopic intervention. Patients showed significant improvement in VAS and mHHS 6 months postoperatively and at final follow-up. The average patient satisfaction was 9.2 at 6 months postoperative and 7.9 at final follow-up. None of our patients experienced any complications. At the final follow-up, there was neither clinical nor radiological evidence of cyst recurrence.

Conclusions

Arthroscopic treatment of the iliopectineal cyst is a feasible and safe alternative to open surgery resulting in significant improvement of clinical and functional outcomes.

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References

  1. Wunderbaldinger P, Bremer C, Schellenberger E et al (2002) Imaging features of iliopsoas bursitis. Eur Radiol 12:409–415. https://doi.org/10.1007/s003300101041

    Article  CAS  PubMed  Google Scholar 

  2. Ginesty E, Dromer C, Galy-Fourcade D et al (1998) Iliopsoas bursopathies. A review of twelve cases. Rev du Rhum (English Ed) 65:181–186

    CAS  Google Scholar 

  3. Anderson CN (2016) Iliopsoas: pathology, diagnosis, and treatment. Clin Sports Med 35:419–433. https://doi.org/10.1016/j.csm.2016.02.009

    Article  PubMed  Google Scholar 

  4. Kuroyanagi G, Yamada K, Imaizumi T et al (2013) Leg lymphedema caused by iliopectineal bursitis associated with destruction of a rheumatoid hip joint: a case report. Exp Ther Med 6:887–890. https://doi.org/10.3892/etm.2013.1243

    Article  PubMed  PubMed Central  Google Scholar 

  5. Kataoka M, Torisu T, Nakamura M, Uchida K (1995) Iliopsoas bursa of the rheumatoid hip joint. A case report and review of the literature. Clin Rheumatol 14:358–364. https://doi.org/10.1007/BF02208355

    Article  CAS  PubMed  Google Scholar 

  6. Kälicke T, Wick M, Frangen TM et al (2005) Iliopsoas tendinitis - Rare cause of pain following implantation of a total hip endoprosthesis. Unfallchirurg 108:1078–1080. https://doi.org/10.1007/s00113-005-0981-5

    Article  PubMed  Google Scholar 

  7. Choi JS, Chung KC, Kim JH (2007) Iliopsoas bursitis following total hip replacement arthroplasty—a case report. J Korean Orthop Assoc 42:410–415. https://doi.org/10.4055/jkoa.2007.42.3.410

    Article  Google Scholar 

  8. Cheung YM, Gupte CM, Beverly MJ (2004) Iliopsoas bursitis following total hip replacement. Arch Orthop Trauma Surg 124:720–723. https://doi.org/10.1007/s00402-004-0751-9

    Article  CAS  PubMed  Google Scholar 

  9. Jerosch J, Neuhäuser C, Sokkar SM (2013) Arthroscopic treatment of iliopsoas impingement (IPI) after total hip replacement. Arch Orthop Trauma Surg 133:1447–1454. https://doi.org/10.1007/s00402-013-1806-6

    Article  PubMed  Google Scholar 

  10. Steinmetz S, Rougemont AL, Peter R (2016) Pigmented villonodular synovitis of the hip. EFORT Open Rev 1:260–266. https://doi.org/10.1302/2058-5241.1.000021

    Article  PubMed  PubMed Central  Google Scholar 

  11. Brunot S, Dubeau S, Laumonier H et al (2013) Acute inguinal pain associated with iliopectineal bursitis in four professional soccer players. Diagn Interv Imaging 94:90–94. https://doi.org/10.1016/j.diii.2012.10.009

    Article  Google Scholar 

  12. Tatsumura M, Mishima H, Shiina I et al (2008) Femoral nerve palsy caused by a huge iliopectineal synovitis extending to the iliac fossa in a rheumatoid arthritis case. Mod Rheumatol 18:81–85. https://doi.org/10.1007/s10165-007-0009-9

    Article  PubMed  Google Scholar 

  13. Stadelmann A, Waldis M, von Hochstetter A, Schreiber A (1992) Nerve compression syndrome caused by synovial cyst of the hip joint. Z Orthop Ihre Grenzgeb 130:125–128

    Article  CAS  Google Scholar 

  14. Gresser J, Bitz K, Binswanger R, Hegglin J (1992) Bursitis iliopectinea–a rare differential diagnosis of painful inguinal swelling. Helv Chir Acta 59:383–388

    CAS  PubMed  Google Scholar 

  15. Harper MC, Schaberg JE, Allen WC (1987) Primary iliopsoas bursography in the diagnosis of disorders of the hip. Clin Orthop Relat Res 221:238–241. https://doi.org/10.1097/00003086-198708000-00030

    Article  Google Scholar 

  16. Nestorova R, Vlad V, Petranova T et al (2012) Ultrasonography of the hip. Med Ultrason 14:217–224

    PubMed  Google Scholar 

  17. Skiadas V, Koutoulidis V, Plotas A (2009) An atypical case of noninfected iliopsoas bursitis—MRI findings. J Radiol Case Rep 3:15–18. https://doi.org/10.3941/jrcr.v3i10.326

    Article  PubMed  PubMed Central  Google Scholar 

  18. Gong E, Jia B, Shi Z et al (2008) CT/MRI image characteristics of iliopsoas bursitis in avascular necrosis of femoral head. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 22:295–298

    PubMed  Google Scholar 

  19. Schmitz MR, Campbell SE, Fajardo RS, Kadrmas WR (2012) Identification of acetabular labral pathological changes in asymptomatic volunteers using optimized, noncontrast 1.5-T magnetic resonance imaging. Am J Sports Med 40:1337–1341. https://doi.org/10.1177/0363546512439991

    Article  PubMed  Google Scholar 

  20. Murphy CL, Meaney JFM, Rana H et al (2010) Giant iliopsoas bursitis: a complication of chronic arthritis. J Clin Rheumatol 16:83–85. https://doi.org/10.1097/RHU.0b013e3181d072bb

    Article  PubMed  Google Scholar 

  21. Ford MJ, Martynoga AG, Nuki G (1981) Iliopsoas Bursitis in Rheumatoid Arthritis: An Unusual Cause of Leg Oedema. Br Med J (Clin Res Ed) 282:947–948. https://doi.org/10.1136/bmj.282.6268.947

    Article  CAS  Google Scholar 

  22. Nunley RM, Wilson JM, Gilula L et al (2010) Iliopsoas bursa injections can be beneficial for pain after total hip arthroplasty. Clin Orthop Relat Res 486:519–526. https://doi.org/10.1007/s11999-009-1141-y

    Article  Google Scholar 

  23. Matsumoto H, Yamamoto E, Kamiya C et al (2012) Femoral vein compression resulting from a ganglion of the hip joint: a case report. Ann Vasc Dis 5:233–236. https://doi.org/10.3400/avd.cr.12.00025

    Article  PubMed  PubMed Central  Google Scholar 

  24. Colasanti M, Sapienza P, Moroni E et al (2006) An unusual case of synovial cyst of the hip joint presenting as femoral vein compression and severe lower limb edema. Eur J Vasc Endovasc Surg 32:468–470. https://doi.org/10.1016/j.ejvs.2006.05.012

    Article  CAS  PubMed  Google Scholar 

  25. Lee KH, Park YS, Lim SJ (2013) Arthroscopic treatment of symptomatic paralabral cysts in the hip. Orthopedics 36:e373–e376. https://doi.org/10.3928/01477447-20130222-29

    Article  PubMed  Google Scholar 

  26. Kanauchi T, Suganuma J, Mochizuki R, Uchikawa S (2014) Arthroscopic treatment of femoral nerve paresthesia caused by an acetabular paralabral cyst. Orthopedics 37:e496–e499. https://doi.org/10.3928/01477447-20140430-62

    Article  PubMed  Google Scholar 

  27. Kohn MD, Sassoon AA, Fernando ND (2016) Classifications in Brief: Kellgren–Lawrence classification of osteoarthritis. Clin Orthop Relat Res 474:1886–1893. https://doi.org/10.1007/s11999-016-4732-4

    Article  PubMed  PubMed Central  Google Scholar 

  28. Ficat RP (1985) Idiopathic bone necrosis of the femoral head. Early diagnosis and treatment. J Bone Jt Surg Ser B 67:3–9. https://doi.org/10.1302/0301-620x.67b1.3155745

    Article  CAS  Google Scholar 

  29. Hawker GA, Mian S, Kendzerska T, French M (2011) Measures of adult pain: visual analog scale for pain (VAS Pain), numeric rating scale for pain (NRS Pain), McGill pain questionnaire (MPQ), short-form McGill pain questionnaire (SF-MPQ), chronic pain grade scale (CPGS), short Form-36 bodily pain scale (SF). Arthritis Care Res 63:240–252. https://doi.org/10.1002/acr.20543

    Article  Google Scholar 

  30. Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. J Bone Jt Surg Am 51:737–755

    Article  CAS  Google Scholar 

  31. Marchetti P, Binazzi R, Vaccari V et al (2005) Long-term results with cementless fitek (or fitmore) cups. J Arthroplasty 20:730–737. https://doi.org/10.1016/j.arth.2004.11.019

    Article  PubMed  Google Scholar 

  32. Hartigan DE, Perets I, Yuen LC, Domb BG (2017) Results of hip arthroscopy in patients with MRI diagnosis of subchondral cysts—a case series. J Hip Preserv Surg 4:324–331. https://doi.org/10.1093/jhps/hnx034

    Article  PubMed  PubMed Central  Google Scholar 

  33. Johnston CAM, Wiley JP, Lindsay DM, Wiseman DA (1998) Iliopsoas bursitis and tendinitis. A review Sport Med 25:271–283. https://doi.org/10.2165/00007256-199825040-00005

    Article  CAS  Google Scholar 

  34. Koudela K, Koudelová J, Koudela K, Kunesová M (2008) Bursitis iliopectinea. Acta Chir Orthop Traumatol Cech 75:347–354

    PubMed  Google Scholar 

  35. Orozco Merino MY, Lasca L (2016) Iliopectineal bursitis. Rev Fac Cien Med Univ Nac Cordoba 73:306

    PubMed  Google Scholar 

  36. Tateiwa T, Shinmura K, Ko M et al (2009) Iliopectineal bursitis associated with rapid destruction of a rheumatoid hip joint. J Orthop Sci 14:455–458. https://doi.org/10.1007/s00776-009-1354-7

    Article  PubMed  Google Scholar 

  37. Gomes EA, Cerqueira LM (2010) Iliopectineal bursitis: case report. Rev Bras Reumatol 50:590–595

    Article  Google Scholar 

  38. Bianchi S, Martinoli C, Keller A, Bianchi-Zamorani MP (2002) Giant iliopsoas bursitis: sonographic findings with magnetic resonance correlations. J Clin Ultrasound 30:437–441. https://doi.org/10.1002/jcu.10093

    Article  PubMed  Google Scholar 

  39. Jerosch J, Sokkar S (2017) The iliopectineal bursitis—arthroscopic treatment. Orthop und Unfallchirurgische Prax 12:624–627. https://doi.org/10.3238/oup2017.0624-0627

    Article  Google Scholar 

  40. Jerosch J (2020) Bursitis iliopectinea—eine seltene Differenzialdiagnose bei Leistenschmerz. Orthopädie Rheuma 23:24–26. https://doi.org/10.1007/s15002-020-2810-1

    Article  Google Scholar 

  41. Jerosch J, Neuhäuser C (2010) Arthroskopische therapie der Bursitis iliopectinea. Orthopädische Prax 46:506–509

    Google Scholar 

  42. Kuiken DS, ten Have BLEF, van Raay JJAM (2008) A swollen leg after total hip arthroplasty. Ned Tijdschr Geneeskd 152:1634–1639

    CAS  PubMed  Google Scholar 

  43. Iwata T, Nozawa S, Ohashi M et al (2013) Giant iliopectineal bursitis presenting as neuropathy and severe edema of the lower limb: case illustration and review of the literature. Clin Rheumatol 32:721–725. https://doi.org/10.1007/s10067-013-2223-5

    Article  PubMed  Google Scholar 

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Funding

None of the authors received financial support for this study.

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Authors and Affiliations

  1. Department of Orthopedics, Trauma and Sport Medicine, Johanne Etienne Hospital, Neuss, Germany

    Jörg Jerosch

  2. Department of Orthopedic Surgery and Trauma, Suez Canal University Hospitals, Kilo 4.5 Ring Road, Ismailia, 41111, Egypt

    Sherif Sokkar, Ahmed El-Tayar & Asser Sallam

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  1. Jörg Jerosch
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  2. Sherif Sokkar
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  4. Asser Sallam
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Correspondence to Asser Sallam.

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The study was approved by the Suez Canal University Institutional Research Board (IRB).

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The entrance to the iliopectineal cyst was located anteromedial close to the area where the iliopsoas tendon was crossing the anterior capsule; clockwise, it was about the one O’clock position. The cyst was widely opened, and contents were removed with an arthroscopic shaver and at the same time the cyst wall was carefully scrapped (MPG 4416 kb)

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Jerosch, J., Sokkar, S., El-Tayar, A. et al. Minimum 5-year follow-up of arthroscopic treatment of symptomatic iliopectineal cyst. Eur J Orthop Surg Traumatol 31, 1369–1374 (2021). https://doi.org/10.1007/s00590-021-02877-6

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  • DOI: https://doi.org/10.1007/s00590-021-02877-6

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