Medium-term and long-term outcomes of interventions for primary psoas tendinopathy.

Objective:To assess medium- and long-term outcomes of psoas tendinopathy to psoas tenotomy and image-guided steroid injections.Design:This is a 14-year retrospective case-control study to identify the efficacy of psoas tenotomy and image-guided steroid injections.Setting:This study was undertaken in a secondary care setting.Patients:Patients with confirmed psoas tendinopathy were followed up by postal questionnaire, which included a nonarthritic hip score (NAHS) and a study patient satisfaction questionnaire.Interventions:Patients underwent image-guided steroid injections. Depending on the analgesic or symptomatic relief, some patients proceeded to psoas tenotomy.Main Outcome Measures:Response to steroid injection. Pain relief and symptomatic relief after the surgery.Results:Twenty-three patients were reviewed with a 70% follow-up over a time of 49 months for surgery (range, 13-144 months) and 77 months for injection (range, 14-160 months). Eight patients had a lasting response to injection and required no further intervention, and 15 patients proceeded to psoas tenotomy using a medial Ludloff approach. The average NAHS scores after the surgery and injection were 66.15 and 76.08, respectively. Ten patients reported pain relief after their tenotomy, and 5 patients reported no change in pain. All 8 patients, who only underwent injection, reported lasting pain relief.Conclusions:Local steroid injections can provide long-term relief for patients presenting with psoas tendinopathy. For those patients with only temporary relief from injection, psoas tenotomy can provide good long-term pain relief.