Karl F Schüttler1, Rose Schramm2, Bilal F El-Zayat2, Markus D Schofer3, Turgay Efe2,4, Thomas J Heyse2. 1. Center of Orthopedics and Trauma Surgery, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany. kschuett@med.uni-marburg.de. 2. Center of Orthopedics and Trauma Surgery, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany. 3. ORTHOmedic, Offenbach, Germany. 4. Orthopaedicum Lich, Lich, Germany.
Abstract
INTRODUCTION: The aim of the present study was to determine the incidence and type of complications during and after hip arthroscopy as well as the effect of the surgeon's learning curve on the occurrence of complications. We expect that the currently reported prevalence especially of minor complications is likely to be underreported in most retrospective series based on chart analysis. MATERIALS AND METHODS: The study included all consecutive patients who underwent hip arthroscopy between 2006 and 2014 at a minimum follow-up of 6 weeks starting with the first patient undergoing hip arthroscopy at the institution. Patient outcome was evaluated using the WOMAC score, VAS for pain, SF-36 questionnaire and the hip-outcome score. Additionally, intra- and postoperative complications were recorded via a questionnaire and additional review of patient files. RESULTS: We identified 529 patients who underwent hip arthroscopy between 2006 and 2014. Complete data could be gathered from 485 patients (91.7%). Major complications occurred in three patients (0.6%; fractures of the femoral neck requiring surgical treatment in one case). Minor complications that did not require further intervention were self-limiting postoperative temporary neurapraxia, hematoma, self-limiting dyspareunia, deep vein thrombosis and impaired wound healing, with hematoma and temporary paresthesia due to traction neurapraxia being the most common ones (22.5 and 16.4% respectively). The overall re-operation rate was 15.7% with conversion to total hip arthroplasty being the most common (11.9%). CONCLUSIONS: The overall major complication rate was low and thus hip arthroscopy can be rated as a safe procedure. But minor complications such as hematoma and temporary paresthesia due to traction neurapraxia are common and currently underreported. Surgeons' learning curves show a reduction of major complications once 60 procedures per surgeon per year is surpassed.
INTRODUCTION: The aim of the present study was to determine the incidence and type of complications during and after hip arthroscopy as well as the effect of the surgeon's learning curve on the occurrence of complications. We expect that the currently reported prevalence especially of minor complications is likely to be underreported in most retrospective series based on chart analysis. MATERIALS AND METHODS: The study included all consecutive patients who underwent hip arthroscopy between 2006 and 2014 at a minimum follow-up of 6 weeks starting with the first patient undergoing hip arthroscopy at the institution. Patient outcome was evaluated using the WOMAC score, VAS for pain, SF-36 questionnaire and the hip-outcome score. Additionally, intra- and postoperative complications were recorded via a questionnaire and additional review of patient files. RESULTS: We identified 529 patients who underwent hip arthroscopy between 2006 and 2014. Complete data could be gathered from 485 patients (91.7%). Major complications occurred in three patients (0.6%; fractures of the femoral neck requiring surgical treatment in one case). Minor complications that did not require further intervention were self-limiting postoperative temporary neurapraxia, hematoma, self-limiting dyspareunia, deep vein thrombosis and impaired wound healing, with hematoma and temporary paresthesia due to traction neurapraxia being the most common ones (22.5 and 16.4% respectively). The overall re-operation rate was 15.7% with conversion to total hip arthroplasty being the most common (11.9%). CONCLUSIONS: The overall major complication rate was low and thus hip arthroscopy can be rated as a safe procedure. But minor complications such as hematoma and temporary paresthesia due to traction neurapraxia are common and currently underreported. Surgeons' learning curves show a reduction of major complications once 60 procedures per surgeon per year is surpassed.
Authors: Bejan A Alvandi; Steven R Dayton; Matthew J Hartwell; Erik B Gerlach; Peter R Swiatek; John J Carney; Vehniah K Tjong Journal: Curr Rev Musculoskelet Med Date: 2022-08-02
Authors: Thomas D Alter; Derrick M Knapik; Martina Guidetti; Alejandro Espinoza; Jorge Chahla; Shane J Nho; Philip Malloy Journal: Orthop J Sports Med Date: 2022-05-06
Authors: Jesus Mas Martinez; Carmen Verdu-Roman; David Bustamante Suarez de Puga; Manuel Morales Santias; Enrique Martinez Gimenez; Javier Sanz-Reig Journal: Arch Orthop Trauma Surg Date: 2021-11-12 Impact factor: 2.928
Authors: Jonathan D Bartlett; John E Lawrence; Matthew Yan; Borna Guevel; Max E Stewart; Emmanuel Audenaert; Vikas Khanduja Journal: Arch Orthop Trauma Surg Date: 2020-01-27 Impact factor: 3.067