Is the Iliopsoas a Femoral Head Stabilizer? A Systematic Review

Takashi Hirase, Jason Mallett, Lindsay E Barter, David Dong, Patrick C McCulloch, Joshua D Harris

Research output: Contribution to journalReview article

Abstract

Purpose: To perform a systematic review of biomechanical and clinical studies to determine whether the iliopsoas is a femoral head stabilizer.

Methods: A systematic review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Inclusion criteria were any human clinical (Levels I-IV evidence) or laboratory studies that investigated the role of the iliopsoas as a stabilizer of the hip. Exclusion criteria included studies that investigated patients undergoing spine surgery or those with a total hip arthroplasty or hip hemiarthroplasty. Study methodologic quality for clinical-outcomes studies were analyzed using the Modified Coleman Methodology Score. Because of the heterogeneity in the participants and interventions, no quantitative assimilative meta-analysis was performed.

Results: Eight articles were analyzed (3 biomechanical [35 cadavers and 18 healthy subjects]; 5 clinical outcomes studies [537 subjects, 207 arthroscopic iliopsoas tenotomies]). Two in vivo biomechanical studies identified the iliopsoas as an anterior hip stabilizer. One cadaveric study identified the iliopsoas as a femoral head stabilizer at 0o-15o of hip flexion. Two clinical studies demonstrated the role of the iliopsoas as a dynamic hip stabilizer, particularly in patients with increased femoral version (greater than 15˚-25˚). Two studies reported cases of atraumatic anterior hip dislocations after arthroscopic iliopsoas tenotomies.

Conclusions: Evidence from biomechanical and clinical studies may suggest that the iliopsoas is a dynamic anterior femoral head stabilizer.

Level of Evidence: Level IV, systematic review of Level III and IV plus biomechanical studies.

Original languageEnglish (US)
Pages (from-to)e847-e853
JournalArthroscopy, sports medicine, and rehabilitation
Volume2
Issue number6
DOIs
StatePublished - Dec 2020

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