Evidence map›Paper›PMID 40410951›Full record

SynthesisOrthopaedic surgery2025

Multilevel Meta-Analysis of Treatment Options for Patients With Iliopsoas Impingement Syndrome After Total Hip Arthroplasty.

Nikolai Ramadanov, Maximilian Voss, Robert Hable, Robert Prill, Dobromir Dimitrov, Marco Ezechieli, Ingo J Banke, Roland Becker

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Orthopaedic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Nikolai RamadanovCenter of Orthopaedics and Traumatology, Brandenburg Medical School, University Hospital Brandenburg an der Havel, Brandenburg an der Havel, Germany.ORCID https://orcid.org/0000-0003-4669-8187
Maximilian VossCenter of Orthopaedics and Traumatology, Brandenburg Medical School, University Hospital Brandenburg an der Havel, Brandenburg an der Havel, Germany.ORCID https://orcid.org/0009-0001-7843-9334
Robert HableFaculty of Applied Computer Science, Deggendorf Institute of Technology, Deggendorf, Germany.
Robert PrillCenter of Orthopaedics and Traumatology, Brandenburg Medical School, University Hospital Brandenburg an der Havel, Brandenburg an der Havel, Germany.
Dobromir DimitrovDepartment of Surgical Diseases, Faculty of Medicine, Medical University of Pleven, Pleven, Bulgaria.
Marco EzechieliCenter of Orthopaedics and Traumatology, Vincenz Hospital Paderborn, Paderborn, Germany.
Ingo J BankeClinic of Orthopedics and Sports Orthopedics, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.ORCID https://orcid.org/0000-0002-0395-3099
Roland BeckerCenter of Orthopaedics and Traumatology, Brandenburg Medical School, University Hospital Brandenburg an der Havel, Brandenburg an der Havel, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveIliopsoas impingement (IPI) syndrome is a significant complication following total hip arthroplasty (THA), often leading to pain and reduced hip function. Despite its clinical relevance, the optimal treatment strategy remains unclear, with varying success rates reported across different interventions. This study aims to compare four treatment options (endoscopic, acetabular cup revision, open tenotomy and conservative management) for patients with IPI syndrome after THA by comparing outcomes in terms of function, pain, complications, and reoperations through a multilevel meta-analysis.

methodsA literature search was conducted in the following databases until 30 November 2024: PubMed, CENTRAL, Epistemonikos, and Embase. A frequentist multilevel meta-analysis was performed using a random effects model with an inverse variance and restricted maximum likelihood heterogeneity estimator with Hartung-Knapp adjustment. Means with 95% confidence intervals (CIs) were calculated separately in the four treatment groups. Then, a test for subgroup differences in multilevel meta-analysis was performed to determine whether there is a statistically significant difference between the means of the four groups.

resultsThe systematic review included 15 studies with 425 patients. The test for subgroup differences showed no statistically significant difference between the four treatment subgroups in Harris Hip Score (HHS) post-intervention (F = 2.0; df = 3, 7; p = 0.20), in HHS difference (F = 2.0; df = 3, 6; p = 0.22), and in functional minimal clinically important differences (MCID) post-intervention (F = 1.0; df = 3, 2; p = 0.42). The conservative management group exhibited the lowest mean HHS (70.3 points).

conclusionsSurgical interventions, including endoscopic tenotomy, acetabular cup revision, and open tenotomy, are effective in achieving meaningful functional improvements in IPI patients. While conservative management was the least effective of all treatment groups, the differences did not reach statistical significance.

Indexed as

Arthroplasty, Replacement, HipPostoperative ComplicationsConservative TreatmentEndoscopyHumansReoperationTenotomyacetabular cup revisionconservative managementendoscopic tenotomyiliopsoas impingementmeta‐analysistotal hip arthroplasty

Identifiers

PMID40410951
PMCPMC12214397

What Socratic holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.