TY - JOUR
T1 - Is the Iliopsoas a Femoral Head Stabilizer? A Systematic Review
AU - Hirase, Takashi
AU - Mallett, Jason
AU - Barter, Lindsay E.
AU - Dong, David
AU - McCulloch, Patrick C.
AU - Harris, Joshua D.
N1 - Funding Information:
The authors report the following potential conflicts of interest or sources of funding: P.C.M. is on the speaker's bureau and is paid for presentation by Vericel/Aastroom Biosciences, receives research support from DePuy, A Johnson & Johnson Company and Arthrex/Medinc of Texas, and is on the editorial/governing board of Journal of Knee Surgery and Orthobullets.com. J.D.H. is on the board or is a committee member of the American Orthopaedic Society for Sports Medicine and Arthroscopy and the Arthroscopy Association of North America, receives research support from Arthrex/Medinc of Texas, DePuy and A Johnson & Johnson, is on the editorial or governing board of Frontiers In Surgery and and Orthobullets.com., is a paid consultant for NIA Magellan, receives publishing royalties and financial or material support from SLACK, is a paid presenter or speaker and a paid consultant and receives research support from Smith & Nephew, and is a paid speaker for Ossur. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Publisher Copyright:
© 2020 Arthroscopy Association of North America. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
PY - 2020/12
Y1 - 2020/12
N2 - 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.
AB - 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.
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U2 - 10.1016/j.asmr.2020.06.006
DO - 10.1016/j.asmr.2020.06.006
M3 - Review article
AN - SCOPUS:85114009502
SN - 2666-061X
VL - 2
SP - e847-e853
JO - Arthroscopy, Sports Medicine, and Rehabilitation
JF - Arthroscopy, Sports Medicine, and Rehabilitation
IS - 6
ER -