Zweifaches Rezidiv nach endoskopischem Iliopsoas-Release bei Hüfttotalendoprothese

A 49-year-old male patient suffered from persistent stab-like pain in the groin and increased tonus of the iliopsoas muscle 4 months after cement-free total hip arthroplasty (THA). The clinical diagnosis of an iliopsoas muscle impingement could be confirmed by a positive diagnostic infiltration of the anterior acetabular rim. After endoscopic iliopsoas muscle release (lesser trochanter) the patient could be discharged without any residual discomfort. After 12 months the patient presented again with the same groin pain after an initial freedom from discomfort over 9 months. The clinical suspicion of a reinsertion of the iliopsoas tendon could be confirmed by metallic artifact reduction sequence magnetic resonance imaging (MARS-MRI) followed by endoscopy (lesser trochanter). Another endoscopic iliopsoas release was carried out and the patient subsequently reported a sudden disappearance of the groin pain. A re-relapse was diagnosed 5 years after the re-release, including 3.5 years without pain. Arthroscopic re-re-release of the iliopsoas tendon (hip joint) was carried out, after which the patient showed a clear improvement of the clinical findings.