Summary

This study compared traditional hip arthroscopy with a perineal post to a new technique without the post, finding that the latter effectively reduces the incidence of perineal complications while maintaining similar surgical outcomes.

Abstract

Background

:Traditional hip arthroscopy with a perineal post is easy to lead to postoperative perineal tissue swelling, nerve injury, skin necrosis, vaginal or scrotal injury and other related complications, which are the main complications of hip arthroscopy. Objective To introduce a new technique of hip arthroscopy without a perineal position in order to reduce the incidence of postoperative perineal complications.

Methods

:Clinical data about patients who underwent hip arthroscopy in our department from November 2021 to January 2022 were collected. These patients were divided into control group (with a perineal post) and observation group (without perineal post) according to the perineal traction during the operation. They underwent physical examination, pain assessment and imaging examination on the day of operation, and 3 days and 3 months after operation to analyze the postoperative perineal complications and surgical efficacy. Results :Totally 43 patients were included, with 20 patients in the control group (16-70 [40.90 ± 15.70] years old, 11 males and 9 females) and 23 patients (13-68 [35.00 ± 12.82] years old, 17 males and 6 females) in the observation group. There was no significant difference in general data between the two groups (P>0.05). The operating time was 85-135 (98.70 ± 13.61) min in the control group and 75-135 (99.60 ± 13.35) min in the observation group, without significant differences (P=0.940). All the patients were followed up. On the day of operation, and the 3rd day and 3 months after operation, the mHHS, iHOT-12 and VAS scores were significantly improved, α-angle, LCEA decreased significantly, and FHNO increased significantly in both of the two groups (all P<0.05). However, there were no significant differences in all the parameters mentioned above between the two groups at the three time points (P>0.05). Two patients developed perineal complications, with one of simple perineal soft tissue crush injury, and 1 of perineal soft tissue crush injury with perineal numbnessin the control group. No perineal complications occurred in the observation group.

Conclusion

:Hip arthroscopy without a perineal post can ensure the normal distraction of joint space during the operation, and can effectively avoid the occurrence of perineal complications during hip arthroscopy operation. The preliminary results showed that it is a safe, convenient and effective procedure.