Psoas tendon release is a procedure to lengthen or release the iliopsoas tendon where it crosses the front of the hip joint. It is performed for painful internal snapping hip or psoas impingement after hip replacement or arthroscopy.
The procedure can be performed arthroscopically (release from inside the hip joint at the level of the labrum) or through a small open incision in the groin (at the lesser trochanter). The tendon is partially cut or lengthened, relieving the snapping and pain. The operation takes 20–40 minutes.
Surgery is recommended for painful internal snapping hip that has not responded to physiotherapy and injection, or for psoas impingement after hip replacement causing painful clunking in the groin.
Physiotherapy (psoas stretching and hip flexor rebalancing), ultrasound-guided corticosteroid injection around the psoas tendon, and activity modification.
Ultrasound or MRI to confirm the diagnosis. Diagnostic injection may help confirm the psoas as the source.
Resolution of painful snapping in approximately 85–90% of patients. Minimal long-term functional impact.
Mild temporary weakness of hip flexion, particularly noticeable going upstairs or getting out of a car.
Local discomfort.
Hip flexion weakness that doesn't fully recover. Uncommon.
Very rare with open approach.
Possible if release is incomplete.
Rare.
General anaesthesia (if arthroscopic) or local/regional anaesthesia (if open).
Walking immediately. Physiotherapy for hip flexor retraining from one to two weeks. Return to full activity at four to six weeks.
Review at six weeks.
Most patients notice mild temporary hip flexion weakness for two to four weeks. It is rarely functionally significant long-term.