Complications in Hip Arthroscopy

Nakano, Nobuaki; Khanduja, Vikas

doi:10.11138/mltj/2016.6.3.402

Cited by 15 publications

(11 citation statements)

References 85 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 5 , 8 , 10 Although this was not evidenced in our study, this finding is similar to that reported by Haskins et al 7 Several studies have recommended the close monitoring of fluid balance and the use of pump pressures between 40 and 50 mm Hg to reduce the risk of extravasation. 12 , 13 …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Intra-abdominal Fluid Extravasation: Is Endoscopic Deep Gluteal Space Exploration a Risk Factor?

Aguilera-Bohórquez

Ramirez

Cantor

et al. 2020

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

Background: The extravasation of fluid into the intra-abdominal space is recognized as a possible complication of hip arthroscopic surgery/endoscopy. The exposure of anatomic areas to elevated pump pressures and high volumes of irrigation fluid increases the risk of fluid leakage into anatomic spaces around the hip joint, especially to the abdomen and pelvis. Purpose: To estimate the incidence and risk factors related to intra-abdominal fluid extravasation (IAFE) after hip endoscopy or arthroscopic surgery. Study Design: Cohort study; Level of evidence, 2. Methods: A prospective study was carried out between June 2017 and June 2018. A total of 106 hip procedures (endoscopy or arthroscopic surgery) performed for extra- or intra-articular abnormalities were included. Before and after surgery, in the operating room, ultrasound was performed by a trained anesthesiologist to detect IAFE. The hepatorenal (Morison pouch), splenorenal, retroaortic, suprapubic (longitudinal and transverse), and pleural spaces were examined. Patients were monitored for 3 hours after surgery to assess for abdominal pain. The data collected included maximum pump pressure, duration and volume of irrigation fluid (Ringer lactate), total surgical time, and traction time. Results: The incidence of IAFE was 31.1% (33/106; 95% CI, 23.1%-40.5%). The frequency of IAFE was 52.9% (9/17) in cases with isolated extra-articular abnormalities and 15.9% (7/44) in cases with isolated femoroacetabular impingement; in cases with both extra- and intra-articular abnormalities, the frequency was 37.8% (17/45). An intervention in the subgluteal space was identified as a risk factor for IAFE (odds ratio, 3.62 [95% CI, 1.47-8.85]). There was no statistically significant difference between groups (with vs without IAFE) regarding total surgical time, maximum pump pressure, or fluid volume. Postoperative abdominal pain was found in 36.4% (n = 12) of cases with IAFE compared with 2.7% (n = 2) of cases without extravasation ( P < .001). No patient with IAFE developed abdominal compartment syndrome. Conclusion: IAFE was a frequent finding after hip arthroscopic surgery/endoscopy in patients with extra-articular abnormalities. Exploration of the subgluteal space may increase the risk of IAFE. Pain and abdominal distension during the immediate postoperative period were early warning signs for IAFE. These results reinforce the need for careful intraoperative and postoperative monitoring by the surgeon and anesthesiologist to identify and avoid complications related to IAFE.

show abstract

Section: Discussionmentioning

confidence: 99%

“… 17 The most common complications are traction-related injuries, chondrolabral damage, deep vein thrombosis, pulmonary embolism, and fluid extravasation. 2 , 12 , 17 …”

mentioning

confidence: 99%

Intra-abdominal Fluid Extravasation: Is Endoscopic Deep Gluteal Space Exploration a Risk Factor?

Aguilera-Bohórquez

Ramirez

Cantor

et al. 2020

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

show abstract

“…It has been hypothesized that suture material may contribute to the development of post-operative capsulolabral adhesion [15, 23]. Capsulolabral adhesions are often seen in revision hip arthroscopy.…”

Section: Discussionmentioning

confidence: 99%

“…This can lead to the development of scar tissue during labral surgery. The presence of suture material has been shown to cause an inflammatory response in rabbit models, and therefore, may contribute to the formation of scar tissue [15, 23].…”

Section: Discussionmentioning

confidence: 99%

Preserving the chondrolabral junction reduces the rate of capsular adhesions

Webb

Devitt

O’Donnell

2019

Journal of Hip Preservation Surgery

View full text Add to dashboard Cite

The operative treatment of pincer-type femoroacetabular impingement (FAI) has become an increasingly more common procedure. Classically, the labrum is incised at the chondrolabral junction (CLJ), or a concurrent tear is extended to allow access to the acetabular rim facilitating acetabuloplasty. The labrum is subsequently repaired using suture anchors. More recently, acetabuloplasty has been performed without incising the labrum and negating the need to use suture anchors. The aim of this study is to determine whether preserving the CLJ reduces the incidence of revision hip arthroscopy for the treatment of capsulolabral adhesions. This retrospective study compared two cohorts of patients undergoing hip arthroscopy for pincer-type FAI from August 2002 to April 2015. The groups analysed were patients undergoing acetabuloplasty with labral repair (LR) and those with no labral repair (NLR). The revision rates and causes for revision were compared using the χ 2 analysis. There were 1010 cases in total. Acetabuloplasty with LR was performed in 546 hips (519 patients), while acetabuloplasty with NLR was performed in 464 hips (431 patients). In the LR group, there were 54 (9.9%) revisions, 25 (46%) of which were due to capsulolabral adhesions. The NLR group had 36 (7.8%) revisions with six (17%) due to capsulolabral adhesions. Preserving the CLJ, thereby avoiding the need for drilling and the insertion of suture anchors, when performing an acetabuloplasty for pincer-type FAI, significantly reduces the rate of symptomatic adhesions requiring revision arthroscopy.

show abstract

“…Apart from patient factors, it is unknown if hip arthroscopy carries increased risk for the development of VTE compared to knee arthroscopy where routine anti-VTE chemoprophylaxis is not recommended. An arthroscopic hip procedure includes foot and ankle immobilization, use of traction, surgical manoeuvres performed in proximity to the deep femoral vein system where thrombi can form and usually spinal or epidural anaesthesia which causes venodilation and blood stasis [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

A systematic review—meta-analysis of venous thromboembolic events following primary hip arthroscopy for FAI: clinical and epidemiologic considerations

Bolia

Fagotti

McNamara

et al. 2018

Journal of Hip Preservation Surgery

View full text Add to dashboard Cite

The purpose of this study was to report the proportion of venous thromboembolic events (VTE) in patients undergoing primary hip arthroscopy for femoroacetabular impingement (FAI) and present a critical overview of the literature to aid in better result interpretation. MedLine, Scopus and Web of Science databases were searched from January 2000 to March 2017. Four thousand-five-hundred and seventy-seven hip cases were included in the meta-analysis of 38 studies. The mean age of patients was 36 ± 1.8 years and the mean follow-up time was 20.6 months. The meta-analysed rate of deep vein thrombosis (DVT) in patients undergoing primary hip arthroscopy for FAI syndrome was 1.18%; 95%CI [0.8–1.74%]; The meta-analysed rate of pulmonary embolism (PE) in patients undergoing primary hip arthroscopy for FAI syndrome was 0.59%; 95%CI [0.38–0.92%]. Quality assessment was performed using the Methodological Index for Non-Randomized Studies (MINORS) criteria the Quality in Prognostic Studies (QUIPS) tool. Sensitivity analysis was conducted to assess for publication bias and its influence on the results. The corrected for publication bias proportion of DVT was 2.02%; 95%CI [1.36–2.99%]. The DVT rate was double following the correction of bias while additional types of bias were detected. Attention must be paid when considering the outcomes of observational studies to make clinical decisions. Insufficient evidence exists to support whether anti-VTE chemoprophylaxis should be administered to patients undergoing primary hip arthroscopy for FAI. Due to the life-threatening character of this complication, the results should serve as starting point to design clinical trials and establish guidelines. Until then, the application of preventive measures against VTE should be decided on a case-by-case basis.

show abstract

Complications in Hip Arthroscopy

Cited by 15 publications

References 85 publications

Intra-abdominal Fluid Extravasation: Is Endoscopic Deep Gluteal Space Exploration a Risk Factor?

Intra-abdominal Fluid Extravasation: Is Endoscopic Deep Gluteal Space Exploration a Risk Factor?

Preserving the chondrolabral junction reduces the rate of capsular adhesions

A systematic review—meta-analysis of venous thromboembolic events following primary hip arthroscopy for FAI: clinical and epidemiologic considerations

Contact Info

Product

Resources

About