Summary

Males, patients with reduced preoperative hip ROM, patients with a lack of joint hypermobility, and males with an elevated BMI require higher initial traction force during postless hip arthroscopy.

Abstract

Background

Higher traction force during hip arthroscopy has been associated with various complications. Previous studies have sought to determine the effects of age, body mass index (BMI), and hip osteoarthritis on traction force during hip arthroscopy. The purpose of this study was to determine the effects of demographic and anatomic factors on traction force required during postless hip arthroscopy.

Methods

A prospective database was used to analyze data on patients undergoing hip arthroscopy by the senior author, including patient sex, age, BMI, Beighton Hypermobility Score (BHS), hip range of motion (ROM) in clinic and under anesthesia, hip dysplasia, acetabular version, and femoral version. All patients underwent postless hip arthroscopy with or without periacetabular osteotomy (PAO). At the initiation of hip arthroscopy, the traction force required to distract the hip joint was measured prior and following inter-portal capsulotomy. Multiple regression analysis was performed to determine the effects of demographic and anatomic factors on measured distraction force.

Results

In total, 352 hips (114 male, 238 female) were included with a mean age of 32.6 years and a mean BMI of 24.1 kg/m2. Mean initial traction force was 109 lbs and decreased to 94.3 lbs following capsulotomy (p<0.0001). The starting traction force was significantly higher in males (p<0.05), patients with a lack of hypermobility (BHS score of 0-2) (p<0.05), and in patients with lower abduction (p<0.05), lower internal rotation (p<0.05), and lower external rotation (p<0.05) on multiple regression analysis. When performing a sub-analysis divided by sex, male patients with elevated BMI required significantly higher starting traction force (p<0.05). Lateral center edge angle, sourcil angle, and the presence of hip dysplasia did not demonstrate a significant correlation with traction force.

Conclusion

Males, patients with reduced preoperative hip ROM, patients with a lack of joint hypermobility, and males with an elevated BMI require higher initial traction force during postless hip arthroscopy. Surgeons should put emphasis on patients’ preoperative ROM and can use this information to discuss the possibility of traction-related complications with patients prior to surgery.