• Kanai Garala, Vishnu Prasad, Kanagaratnam Jeyapalan, and Richard A Power.
• Departments of *Orthopedic Surgery and †Radiology, Leicester General Hospital, University Hospitals Leicester, Leicester, United Kingdom.
• Clin J Sport Med. 2014 May 1;24(3):205-10.

ObjectiveTo assess medium- and long-term outcomes of psoas tendinopathy to psoas tenotomy and image-guided steroid injections.DesignThis is a 14-year retrospective case-control study to identify the efficacy of psoas tenotomy and image-guided steroid injections.SettingThis study was undertaken in a secondary care setting.PatientsPatients with confirmed psoas tendinopathy were followed up by postal questionnaire, which included a nonarthritic hip score (NAHS) and a study patient satisfaction questionnaire.InterventionsPatients underwent image-guided steroid injections. Depending on the analgesic or symptomatic relief, some patients proceeded to psoas tenotomy.Main Outcome MeasuresResponse to steroid injection. Pain relief and symptomatic relief after the surgery.ResultsTwenty-three patients were reviewed with a 70% follow-up over a time of 49 months for surgery (range, 13-144 months) and 77 months for injection (range, 14-160 months). Eight patients had a lasting response to injection and required no further intervention, and 15 patients proceeded to psoas tenotomy using a medial Ludloff approach. The average NAHS scores after the surgery and injection were 66.15 and 76.08, respectively. Ten patients reported pain relief after their tenotomy, and 5 patients reported no change in pain. All 8 patients, who only underwent injection, reported lasting pain relief.ConclusionsLocal steroid injections can provide long-term relief for patients presenting with psoas tendinopathy. For those patients with only temporary relief from injection, psoas tenotomy can provide good long-term pain relief.

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