Iliopsoas Release for Internal Snapping Hip using a Minimally Open Medial Hip Approach-Case Report

Internal snapping hip is a recognized cause of hip pain caused by recurrent subluxation of the iliopsoas tendon. When conservative treatment fails, surgical release of the iliopsoas tendon may be indicated using an arthroscopic or open hip approach. Results have been better with arthroscopic release. We report a case of a 32-year-old active female with a painful internal snapping hip. The right hip extension from a flexed position produced a strong and audible snap. A tenotomy of the iliopsoas in combination with a resection of the lesser trochanter was performed, using a limited medial hip approach different than the one described by Ludloff or Ferguson. The pain and snapping phenomenon were solved; however, a slight heterotopic ossification, as well as a weakness in the flexion of the hip was noted after the procedure, with no functional limitation. The minimally invasive medial hip approach appears to be a simple, reproducible and successful operation for the treatment of an internal snapping hip caused by the iliopsoas tendon, namely in orthopaedics departments with limited experience in hip arthroscopic approach, but it is not superior to arthroscopic release.