Incidence of Nerve Injury After Hip Arthroscopy

Kern, Michael J.; Murray, Ryan S.; Sherman, Thomas I.; Postma, William

doi:10.5435/jaaos-d-17-00230

Cited by 37 publications

(29 citation statements)

References 15 publications

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“…Kern et al . 15 reported the incidence of nerve injury after hip arthroscopy could be up to 13% and the traction related neurapraxia was underestimated previously. Bailey et al 16 .…”

Section: Discussionmentioning

confidence: 98%

“…Frandsen et al 14 reported that up to 74% of patients complained of some kind of traction-related problems after hip arthroscopy, and neurapraxia is the most commonly reported. Kern et al 15 reported the incidence of nerve injury after hip arthroscopy could be up to 13% and the traction related neurapraxia was underestimated previously. Bailey et al 16 reported the mean traction time was 46.5 min, and a longer traction time and a greater traction force could result in groin numbness and pudendal neurapraxia.…”

Section: Traction Time and Traction-related Complicationsmentioning

confidence: 99%

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Longitudinal Capsulotomy in Hip Arthroscopy: A Safe and Feasible Procedure for Cam‐Type Femoracetabular Impingement

Yin

Wang

Liang

et al. 2021

Orthopaedic Surgery

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Objective To evaluate the surgical security, feasibility, and clinical efficacy of the longitudinal outside‐in capsulotomy in hip arthroscopic treatment for cam‐type femoracetabular impingement (FAI). Methods We retrospectively reviewed patients with cam‐type FAI who underwent hip arthroscopy in our institute from January 2018 to June 2019. All hip arthroscopic procedures were performed by one experienced surgeon in the same manner, except the fashions of capsulotomy. Fifty six patients with mean age of 39.1 and mean body mass index (BMI) of 24.5 were categorized into two groups according to the fashions of capsulotomy. Twenty six cases with longitudinal outside‐in capsulotomy were categorized into Group L, and 30 cases with transversal interportal capsulotomy were categorized into Group T as the control group. The demographic parameters were retrieved from medical documents and compared between the two groups. Surgical outcome including overall surgical time, traction time, complications, visual analogue score (VAS), and intraoperative radiation exposure were compared to investigate the security and feasibility. Radiographic assessment, and functional outcome were compared between the two groups to determine the clinical efficacy of the longitudinal capsulotomy. Results There was no significant difference in the demography and duration of follow‐up between the two groups. The overall surgical time demonstrated no significant difference between Group L and Group T (130.8 ± 16.6 min and 134.0 ± 14.7 min, P = 0.490). Significantly decreased traction time was found in Group L (43.2 ± 8.4 min and 62.2 ± 8.6 min, P < 0.001) compared to Group T. The Median of the fluoroscopic shot was 1 and 3 (P < 0.001). No major complications and reoperation were reported in both groups. The case of intraoperative iatrogenic injure was 0 (0%) and 6 (20%) in Group L and Group T respectively (P = 0.035), and the case of postoperative neurapraxia was 0 (0%) and 8 (26.6%) in Group L and Group T respectively (P = 0.017). The Median of postoperative VAS was 2 and 3 in Group L Group T (P = 0.002). The postoperative α angle was 42.3° ± 3.4° and 44.4° ± 3.5° in group L and group T respectively (P = 0.001). The postoperative iHOT‐12 score at final follow‐up was 79.3 ± 6.7 and 77.0 ± 7.9 respectively (P = 0.141). Conclusion Longitudinal outside‐in capsulotomy with less radiation exposure, reduced traction time, and reduced complications could be a safe and feasible procedure in arthroscopic treatment for cam FAI. Its clinical efficacy was not worse compared with traditional interportal capsulotomy in short‐term follow‐up.

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“…Kern et al . 15 reported the incidence of nerve injury after hip arthroscopy could be up to 13% and the traction related neurapraxia was underestimated previously. Bailey et al 16 .…”

Section: Discussionmentioning

confidence: 98%

Section: Traction Time and Traction-related Complicationsmentioning

confidence: 99%

Longitudinal Capsulotomy in Hip Arthroscopy: A Safe and Feasible Procedure for Cam‐Type Femoracetabular Impingement

Yin

Wang

Liang

et al. 2021

Orthopaedic Surgery

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“…4 However, patient safety is of paramount importance, and known potential groin complications are what we all try to avoid. 5,6 With removing the post, we eliminate the possibility of iatrogenic groin injury, but we must ask ourselves, is changing our technique necessary? Those already adopting post-free think so, but studies are needed to show safety and efficacy of post-less arthroscopy.…”

Section: See Related Article On Page 2840mentioning

confidence: 99%

Editorial Commentary: Post-Free Arthroscopy Reduces Complications and Pain: To Post or Not to Post? Is That Still a Question?

Kollmorgen¹

2021

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Post-free hip arthroscopy has garnered much attention over the past several years. The attraction of eliminating groin complications is at the forefront of this technique. Recent studies have shown improved blood flow, safe techniques, but other benefits, if any, are yet to be discovered. For now, those adopting post-free distraction do so to eliminate a source of groin complication, improved access to the cam, and a perceived decrease in pain. Several options exist to achieve post-free distraction, and, as we continue to perfect this technique, continued studies may reveal other advantages or disadvantages to post removal.

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“…[1][2][3] Multiple studies have demonstrated that the majority of neuropraxias related to hip arthroscopy affect the pudendal nerve. [2][3][4] In a prospective study performed by Kern et al, 4 the incidence of nerve injury was 13% (13 of 100 patients), with 9 of these patients The patient is positioned supine and a perineal post is placed only for positioning so the patient does not fall off the bed. Once general anesthesia is performed, the patient is moved to the edge of the table on the side of the surgical hip so that the surgeon does not run into the bed with the hand when holding the camera during the surgical case.…”

mentioning

confidence: 99%

The Hip Arthroscopy Post-less Procedure Impingement (HAPPI) Technique: Achieving Distraction With Standard Hip Tables at Zero Additional Cost

Jimenez

Haneda

Pascual‐Garrido

2020

Arthroscopy Techniques

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Hip arthroscopy is becoming a more common treatment for femoroacetabular impingement, labral tears, and a variety of other hip pathologies. Unlike arthroscopy of the shoulder and knee, hip arthroscopy requires a significant amount of traction to gain access into the joint. Historically, traction has been achieved with the use of a perineal post. The use of a perineal post in hip arthroscopy can cause several avoidable complications such as neuropraxias (i.e., the pudendal nerve), vaginal or scrotal injuries, and perineal skin injuries. Several articles have been proposed using post-less techniques to obtain hip traction, but many of these techniques are expensive and require the purchase of new equipment. The purpose of this Technical Note is to describe a post-less technique for hip arthroscopy, the HAPPI technique (hip arthroscopy post-less procedure impingement), which is more affordable and does not require the addition of any special equipment. In addition, we will review some pearls and pitfalls, as well as advantages and disadvantages of the proposed technique.

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Incidence of Nerve Injury After Hip Arthroscopy

Abstract: Level IV.

Cited by 37 publications

References 15 publications

Longitudinal Capsulotomy in Hip Arthroscopy: A Safe and Feasible Procedure for Cam‐Type Femoracetabular Impingement

Longitudinal Capsulotomy in Hip Arthroscopy: A Safe and Feasible Procedure for Cam‐Type Femoracetabular Impingement

Editorial Commentary: Post-Free Arthroscopy Reduces Complications and Pain: To Post or Not to Post? Is That Still a Question?

The Hip Arthroscopy Post-less Procedure Impingement (HAPPI) Technique: Achieving Distraction With Standard Hip Tables at Zero Additional Cost

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