Arthroscopic treatment of iliopsoas cyst using outside-in technique-surgical technique and clinical outcomes.

Li, Zhi; Ng, Jonathan Patrick; Lu, Guanda; Farha, Ahamed Fazloon Fathima; Hooblal, Atiya Prajna; Wagner, Timoné; Wang, Fusheng; Zhang, Weiguo et al. · J Hip Preserv Surg · 2025

case_series · Level IV

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Abstract

Due to the low prevalence of iliopsoas cysts, as well as the technical challenges involved in locating cysts from outside the joint capsule during arthroscopic surgery, there is a lack of comprehensive arthroscopy technique and clinical literature on this topic. We conducted a retrospective analysis and follow-up of five patients with iliopsoas cysts treated arthroscopically, over the past 3 years. Patient ages ranged from 39 to 73 years, with a mean age of 54 years. Our surgical approach involves the utilization of the outside-in technique to access and excise the cysts, along with potential concurrent procedures such as repair or debridement of the acetabular labrum. Each patient had a follow-up duration exceeding 23 months. The outcomes revealed significant pain relief and hip joint function improvement in all patients postoperatively. The Visual Analogue Scale scores reduced from a mean of 5.75 ± 0.43 preoperatively to 1.00 ± 0.70 postoperatively (<i>P</i> < .01), and the Modified Harris Hip Score increased from 50.75 ± 4.43 to 86.00 ± 4.47 (<i>P</i> < .01). For individuals presenting with symptoms of groin pain in the presence of a radiologically confirmed iliopsoas cyst, hip arthroscopy using the outside-in technique represents a minimally invasive and reliable approach for cyst removal.