Julie S Han1, Dai Sugimoto1,2,3, Maxwell H McKee-Proctor1,3, Andrea Stracciolini1,4,2,3, Pierre A d'Hemecourt1,2,3. 1. Departments of Orthopedics, Division of Sports Medicine. 2. Harvard Medical School, Boston, Massachusetts, USA. 3. Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA. 4. Medicine, Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.
Abstract
OBJECTIVES: Treatment for iliopsoas tendinopathy includes ultrasound (US)-guided iliopsoas peritendinous corticosteroid injection. Evidence is lacking regarding US-guided iliopsoas injection efficacy in patients with iliopsoas tendinopathy and intra-articular (IA) hip abnormalities. The purpose of this study was to examine the efficacy of US-guided iliopsoas corticosteroid injection for iliopsoas tendinopathy in patients with and without IA hip abnormalities. METHODS: This work was a prospective study evaluating patients aged 12 to 50 years with iliopsoas tendinopathy. Participants completed a Hip Disability and Osteoarthritis Outcome Score (HOOS) questionnaire before and 6 weeks after injection. The main outcome measure was the change in HOOS subcategory scores. Independent variables included time and hip status. Normal hips were compared to abnormal hips with IA abnormalities. A 2-way repeated measures analysis of covariance with effect size (η2 ) was used to determine injection effects on HOOS scores before and 6 weeks after injection. RESULTS: A total of 178 patients (154 female and 24 male) were analyzed. Time effects were found for both normal and abnormal hips in all HOOS subcategories: symptoms (P = .041; η2 = 0.050), pain (P = .001; η2 = 0.184), activities of daily living (P = .011; η2 = 0.076), function in sports and recreation (P = .001; η2 = 0.151), and quality of life (QOL; P = .001; η2 = 0.193). Significant differences between normal versus abnormal hips were found in the sports and recreation (P = .032; η2 = 0.056) and QOL scores (P = .001; η2 = 0.135). CONCLUSIONS: In patients with iliopsoas tendinopathy, US-guided iliopsoas corticosteroid injection improved outcomes regardless of coexisting IA hip abnormalities. Patients without IA hip abnormalities showed greater improvement in sports and recreation and QOL scores compared to patients with IA hip abnormalities. Ultrasound-guided iliopsoas injection for iliopsoas tendinopathy may advance short-term care and help continue with nonsurgical treatment regimens.
OBJECTIVES: Treatment for iliopsoas tendinopathy includes ultrasound (US)-guided iliopsoas peritendinous corticosteroid injection. Evidence is lacking regarding US-guided iliopsoas injection efficacy in patients with iliopsoas tendinopathy and intra-articular (IA) hip abnormalities. The purpose of this study was to examine the efficacy of US-guided iliopsoas corticosteroid injection for iliopsoas tendinopathy in patients with and without IA hip abnormalities. METHODS: This work was a prospective study evaluating patients aged 12 to 50 years with iliopsoas tendinopathy. Participants completed a Hip Disability and Osteoarthritis Outcome Score (HOOS) questionnaire before and 6 weeks after injection. The main outcome measure was the change in HOOS subcategory scores. Independent variables included time and hip status. Normal hips were compared to abnormal hips with IA abnormalities. A 2-way repeated measures analysis of covariance with effect size (η2 ) was used to determine injection effects on HOOS scores before and 6 weeks after injection. RESULTS: A total of 178 patients (154 female and 24 male) were analyzed. Time effects were found for both normal and abnormal hips in all HOOS subcategories: symptoms (P = .041; η2 = 0.050), pain (P = .001; η2 = 0.184), activities of daily living (P = .011; η2 = 0.076), function in sports and recreation (P = .001; η2 = 0.151), and quality of life (QOL; P = .001; η2 = 0.193). Significant differences between normal versus abnormal hips were found in the sports and recreation (P = .032; η2 = 0.056) and QOL scores (P = .001; η2 = 0.135). CONCLUSIONS: In patients with iliopsoas tendinopathy, US-guided iliopsoas corticosteroid injection improved outcomes regardless of coexisting IA hip abnormalities. Patients without IA hip abnormalities showed greater improvement in sports and recreation and QOL scores compared to patients with IA hip abnormalities. Ultrasound-guided iliopsoas injection for iliopsoas tendinopathy may advance short-term care and help continue with nonsurgical treatment regimens.