Iliopsoas impingement after hip replacement: lengthening may work even with large overhang

The edition in brief

A retrospective series of 86 hips with iliopsoas impingement after total hip arthroplasty found arthroscopic iliopsoas fractional lengthening gave similar pain, function and satisfaction whether anterior acetabular overhang was under or over 8 mm, with acetabular revision in 1.5% and 5% respectively over a mean 2.5 years. In 97 adolescents after medial patellofemoral ligament reconstruction, an ACL-RSI psychological readiness score of 59.2 or more was the only independent predictor of return to sport (OR 3.56, 95% CI 1.10 to 11.51); 78.3% returned. A case series of 21 knees found high-grade MCL pie-crusting during meniscal root repair left a mean 1.21 mm side-to-side valgus gapping, below the 3.2 mm instability threshold. Among 175 patients undergoing arthroscopy for osteochondral lesions of the talus, 20.6% had occult syndesmotic instability, more likely with higher BMI. The pearl covers the Ottawa ankle rules.