BACKGROUND: Iliopsoas injury is the second most common cause of groin pain in athletes. Treatment includes ultrasound (US)-guided iliopsoas peritendinous injection. Evidence regarding US-guided iliopsoas injection efficacy is lacking in athletes with intra-articular hip abnormalities.
PURPOSE: To examine short-term efficacy of US- guided iliopsoas corticosteroid injection in athletes with and without intra-articular hip pathology.
METHODS: Prospective study design to evaluate athletes 12-50 years with iliopsoas tendonitis. Participants completed a Hip Disability and Osteoarthritis Outcome Score (HOOS) questionnaire prior to US-guided iliopsoas injection and 6-weeks after injection. Outcome measures included change in HOOS subcategory scores. Independent variables included normal hips vs. hips with intra-articular pathology (labral tear, femoroacetabular impingement, osteoarthritis, and dysplasia). Two-way repeated measures analysis of variance (ANOVA) with effect size (η2) was used to determine effects of injection on HOOS scores of patients at baseline and 6-weeks following injection.
RESULTS: 180 patients analyzed; 85.6% (N154) female, mean age: females 20.5±7.5, males 21.5±7.6 years. Time effects were found for both normal and abnormal hips in all five HOOS score subcategories: symptoms (p=0.041, η2=0.050), pain (p=0.001, η2=0.184), activity of daily living (ADL) (p=0.011, η2=0.076), sports/recreation (p=0.001, η2=0.151), and quality of life (QOL) (p=0.001, η2=0.193). Significant differences between normal vs. abnormal hips were found in sports/recreation (p=0.032, η2=0.056) and QOL scores (p=0.001, η2=0.135). Interaction was found for QOL scores only (p=0.031, η2=0.056).
CONCLUSIONS: US-guided iliopsoas injection appears to improve outcomes over the 6 week study period regardless of pre-existing intra-articular hip pathology. Athletes without intra-articular pathology showed greater improvement in sports/recreation and QOL when compared to athletes with abnormal hip pathology. QOL was significantly better in athletes with normal hips than those with hip pathology during 6 weeks. US-guided iliopsoas injections may serve to help patients with iliopsoas tendonitis to advance care and continue with non-surgical treatment regimes.