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A Prospective Comparison Of Groin-Related Complications Following Hip Arthroscopy With Versus Without A Perineal Post

Iciar M Davila Castrodad, MD
UNITED STATES

A Prospective Comparison Of Groin-Related Complications Following Hip Arthroscopy With Versus Without A Perineal Post

Iciar M Davila Castrodad, MD, UNITED STATES Matthew J. Kraeutler, MD, UNITED STATES Omer Mei-Dan, MD, UNITED STATES Anthony Scillia, UNITED STATES

St. Joseph's University Medical Center, Paterson, New Jersey, UNITED STATES

2021 Congress ePoster Presentation Not yet rated

Anatomic Location

Hip / Groin / Thigh

Anatomic Structure

Labrum

Diagnosis / Condition

Tears

Treatment / Technique

Arthroscopy

Sports Medicine

Outcome Studies

Labrum

Labrum Tears Labrum Treatment

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Summary: Our study demonstrated fewer perineal complications among patients who underwent hip arthroscopy without a perineal post.

Purpose

Previous studies have demonstrated rates of perineal nerve and/or soft tissue complications as high as 46% following hip arthroscopy. Recently, the use of the Trendelenburg position and a post-less hip distraction setup has shown early promising outcomes with no reported groin-related complications. The purpose of this study was to compare groin-related nerve and soft tissue complications between patients undergoing hip arthroscopy with versus without the use of a perineal post.

Methods

A prospective, single-surgeon cohort study was performed on all patients undergoing hip arthroscopy by the senior author between January 2020 and January 2021. The Pivot Guardian, post-free hip distraction system (Stryker, Kalamazoo, MI) was used at one center at which the senior author operates, and a Hana table (Mizuho, Union City, CA) with a perineal post (Smith & Nephew, Andover, MA) was used at another surgical location. A survey was completed by each patient at the first postoperative visit (7-10 days postoperatively) to determine if the patient had experienced any groin-related complications following surgery. These included groin numbness, sexual dysfunction, urinary dysfunction, and skin tears. For any patients with a positive survey response, the survey was repeated at each follow-up visit (6 weeks, 3 months, 6 months) until the symptoms resolved. The rate and duration of groin-related complications was then compared between the two groups. Independent samples t-tests were performed to compare continuous variables while chi-squared tests were performed to compare categorical variables.

Results

A total of 43 patients were included in the study, 31 of whom underwent hip arthroscopy with a perineal post and 12 patients without a perineal post. No differences were found between the post and post-less groups in terms of age at surgery (33 ± 14 vs 26 ± 10 years, p = 0.112), sex (52% vs 50% female, p = 0.9243), or body mass index (26 ± 6 vs 28 ± 8, p = 0.343). In addition, average traction time did not significantly differ between the groups (post: 55 ± 18, post-less: 50 ± 11 minutes, p= 0.504). The average Trendelenburg angle among the post-less patients was 12° (range 10-14°). We found that 8 (26%) patients in the perineal post group experienced groin numbness versus 0 (0%) in the post-less group (p=0.049). On average, groin numbness lasted 5 ± 4 days in the perineal post group. We also found that 4 (13%) patients in the perineal post group experienced groin pain versus 2 (17%) in the post-less group (p=0.244). One patient in the perineal post group experienced sexual dysfunction for 5 days. Seven (23%) patients in the perineal post group experienced foot numbness versus 1 (8%) in the post-less group (p=0.168). One patient in the perineal post group experienced foot numbness for 157 days. Six others from the perineal post group also experienced foot numbness which averaged 6 ± 4 days vs 2 days for one patient in the post-less group (p=0.842). Finally, no skin tears were reported in either groups.

Conclusions

In recent years, efforts have been made to decrease perineal complications among hip arthroscopy patients by adjusting intraoperative positioning and setup. Our study demonstrated fewer perineal complications among patients who underwent hip arthroscopy without a perineal post. However, larger studies are warranted to corroborate these findings.

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The Surgeon Mentor Program: Outcomes of Total Hip Arthroplasty via the Direct Anterior Approach ePoster Presentation Christopher J. Wilson, A/Prof, MBChB, MRCS, FRACS, PhD, AUSTRALIA Melinda Jiang, MD, AUSTRALIA Mark Inglis, FRACS BMBS B Med Sci FOrthoA, AUSTRALIA David Morris, MD, AUSTRALIA Nathan Eardley-Harris , MBBS, MClinSc, AUSTRALIA
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Health Literacy in Hip Arthroscopy: A Quantitative Assessment of the Understandability and Readability of Online Patient Education ePoster Presentation Alan Shamrock, MD, UNITED STATES Burke Gao, MD, UNITED STATES Olivia O'Reilly, MD, UNITED STATES Mary Kate Skalitzky, BA, UNITED STATES Trevor Gulbrandsen, MD, UNITED STATES Michael C. Willey, MD, UNITED STATES Robert W. Westermann, MD, UNITED STATES
Efficacy Of Enoxaparin As A Thromboprophylactic Agent In Major Lower Limb Orthopedic Surgeries. ePoster Presentation Raghavendra Raju, MBBS,MS, INDIA Prasad Soraganvi, MBBS, MS, DNB, MRCS, SICOT-dip, INDIA
“X-Square” Technique For Radial Meniscal Root Tear ePoster Presentation Winyou Ratanachai, MD.M Ch(Orth)., THAILAND Keerati Klinchanhom, MD, THAILAND
Can BMAC Application Safely Diminish Perioperative Pain In Patients Undergoing Hip Arthroscopy? Abstract Presentation 5 minutes Michael Peter Kucharik, BS, UNITED STATES Paul F Abraham, BS, UNITED STATES Mark R. Nazal, MPH, UNITED STATES Nathan Varady, MD, MBA, UNITED STATES Wendy Madeline Meek, BBA, UNITED STATES Stephen M Gillinov, AB, UNITED STATES Christopher T Eberlin, BS, UNITED STATES Scott D Martin, MD, UNITED STATES
Hip Arthroscopic Portals:A New Approach Through Accessory Portals Established Within 3Cm Around Anterolateral Portal ePoster Presentation Kiran Kumar Shah, MD, NEPAL
Results After Arthroscopic Treatment Of Iliopsoas Impingement After Total Hip Arthroplasty ePoster Presentation Wolfgang Miehlke, MD, GERMANY Christian Sobau, MD, GERMANY Alexander Zimmerer, MD, GERMANY
Hip Disorders in Bull Riders: Clinical Observations and Outcomes of Arthroscopy Abstract Presentation 6 minutes J.W. Thomas Byrd, MD, UNITED STATES Kay S. Jones, MSN, RN, UNITED STATES
Radiographic Indices Are Not Predictive Of Clinical Outcome Among 1,735 Patients Indicated For Hip Arthroscopy: A Machine Learning Analysis Abstract Presentation 5 minutes Prem N Ramkumar, MD, MBA, UNITED STATES Jaret M Karnuta, MS, UNITED STATES Heather S Haeberle, MD, UNITED STATES Spencer Sullivan, BS, UNITED STATES Danyal H. Nawabi, MD, FRCS(Orth), UNITED STATES Anil S. Ranawat, MD, UNITED STATES Bryan T. Kelly, MD, UNITED STATES Benedict U. Nwachukwu, MD, MBA, UNITED STATES
Cleft Sign and Bone Marrow Edema of the Pubic Synthesis are Associated with Sports Activity and Bony Morphology Related to Femoroacetabular Impingement in Symptomatic Patients with Labral Tears: A Cohort Study Abstract Presentation 5 minutes Keisuke Nakayama, MD, PhD, JAPAN Hajime Utsunomiya, MD, PhD, JAPAN Soshi Uchida, MD, PhD, JAPAN
Persistent Post-Operative Opioid Use Following Hip Arthroscopy Is Common And Is Associated With Pre-Operative Opioid Use And Age ePoster Presentation Ryan M. Degen, MD, FRCSC, CANADA J. Andrew McClure, MSc, CANADA Britney Le, MSc, CANADA Blayne Welk, MD, CANADA Jacquelyn Marsh, PhD, CANADA
Solving Social Inequality In Surgical Outcomes By Combining Standardized Treatment And Individualized Patient Education ePoster Presentation Benjamin Saks, MD, UNITED STATES Vivian Ouyang, BS, UNITED STATES Andrew Jimenez, MD, UNITED STATES Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
Arthroscopic Tendon Release for Iliopsoas Impingement after Total Hip Arthroplasty ePoster Presentation Michael Andreas Finsterwald, MD, AUSTRALIA Georgina Waters, MD, AUSTRALIA Jay R. Ebert, PhD, AUSTRALIA Christopher W. Jones, FAOrthA FRACS PhD MBBS(Hons) BEng(Hons) BCom, AUSTRALIA Piers Yates, MBBS(Hons) BSc(Hons) MRCS(Eng) FRCS(Tr & Orth) FRA, AUSTRALIA Peter Alberto D'Alessandro, MBBS Hons. (UWA) FRACS FAOrthA, AUSTRALIA
Not Every Hip Impingement Requires Hip Arthroscopy. Abstract Presentation 5 minutes Vitali Goriainov, FRCS (Orth), BM, PhD, MSc, UNITED KINGDOM Mohamed Zubair Farook, MBBS, D.Ortho, FRCS (Orth), UNITED KINGDOM Rajiv Kaila, MRCS, MSc, MFSEM(UK), FEBOT, UNITED KINGDOM Tom CB Pollard, MD, FRCS (Tr & Orth), UNITED KINGDOM Antonio J. M. D. Andrade, MB BS, M.Sc., FRCS(Tr&Orth), UNITED KINGDOM
Risk Factors For Early Conversion To Hip Arthroplasty Following Hip Arthroscopy: A Matched Cohort Analysis Abstract Presentation 4 minutes Joseph J. Ruzbarsky, MD, UNITED STATES Max Seiter, MD, UNITED STATES Rui Soares, BS, UNITED STATES Lauren Pierpoint, PhD, UNITED STATES Karen K. Briggs, MPH, MBS, UNITED STATES Marc J. Philippon, MD, UNITED STATES
Health Literacy in Periacetabular Osteotomy Procedure: A Quantitative Assessment of the Readability, Understandability and Actionability of Online Patient Education Material ePoster Presentation Alan Shamrock, MD, UNITED STATES Trevor Gulbrandsen, MD, UNITED STATES Burke Gao, MD, UNITED STATES Mary Kate Skalitzky, BA, UNITED STATES Robert W. Westermann, MD, UNITED STATES Michael C. Willey, MD, UNITED STATES
A Comparison Of Perioperative Outcomes Between Patients Who Underwent Hip Arthroscopy With And Without The Pericapsular Nerve Group Block ePoster Presentation Albert A Yusupov, MD, UNITED STATES Iciar M Davila Castrodad, MD, UNITED STATES Matthew J. Kraeutler, MD, UNITED STATES Christopher J Mazzei, MD, UNITED STATES Stephen A. Hunt, MD Kimberly V Tucker, MD, UNITED STATES Anthony Scillia, UNITED STATES Patrick A Armstrong, MD, UNITED STATES Mathew S Chow, MD, UNITED STATES Richard A Stennett, MD, UNITED STATES James C Wittig, MD
Total Hip Arthroplasty (THA) after Previous Hip Arthroscopy: A Mid-Term Functional and Clinical Comparison with Index THA Abstract Presentation 5 minutes Kelsi Greenwood, BScHons, SOUTH AFRICA Jurek R. T. Pietrzak, MBBCh, FCS(SA)Orth, UNITED KINGDOM Zia Maharaj, MBChB(Pret), SOUTH AFRICA Josip N. Cakic, MD, PhD, FCS(SA)Orth, MMed(Orth)WITS, SOUTH AFRICA
Predicting Dissatisfaction Following Total Hip Arthroplasty Using A Bayesian Model Averaging (Bma) Approach: Results From The Australian Arthroplasty Clinical Outcomes Registry (Acorn) ePoster Presentation Jan Peter Van Meirhaeghe, MD, BELGIUM Rob Molnar, MBBS, AUSTRALIA Sam Adie, BSc(Med) MBBS MSpMed MPH PhD FRACS, AUSTRALIA
Stem Cells Injection And Percutaneous Femoral Head Decompression - An Extremely Rare Procedure With Good Results ePoster Presentation Sofia Moura De Carvalho, MD, PORTUGAL Inês Domingues, MD, PORTUGAL Liliana Domingues, MD, PORTUGAL Eduardo Ramalho Silva, MD, PORTUGAL Gonçalo Lavareda, MD, PORTUGAL Filipe Machado, MD, PORTUGAL Rita Ricardo, MD, PORTUGAL

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A Prospective Comparison Of Groin-Related Complications Following Hip Arthroscopy With Versus Without A Perineal Post

A Prospective Comparison Of Groin-Related Complications Following Hip Arthroscopy With Versus Without A Perineal Post

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A Prospective Comparison Of Groin-Related Complications Following Hip Arthroscopy With Versus Without A Perineal Post

A Prospective Comparison Of Groin-Related Complications Following Hip Arthroscopy With Versus Without A Perineal Post

Purpose

Methods

Results

Conclusions

More ISAKOS 2021: Global Content