Complications with hip arthroscopy and open hip surgery

Recognition of femoroacetabular impingement as a potential precursor to hip osteoarthritis has led to the development of both open and arthroscopic hip preservation surgery. Successful short- and midterm clinical outcomes have been reported following hip preservation surgery. Improvements in technique and instrumentation have led to a dramatic increase in the number of surgeons performing hip arthroscopy and the number of cases performed internationally.However, there is a significant learning curve associated with hip arthroscopy. Although the rate of minor complications is low (7.5 %), it is largely related to the learning curve. The two most common minor complications are iatrogenic chondrolabral injury and temporary neuropraxia. Open surgical hip dislocation permits a 360 A view of the femoral head and acetabulum but requires a larger incision, greater soft tissue dissection, and a trochanteric osteotomy. Although the rate of minor complications is reportedly higher following open surgical hip dislocation due to the occasional development of painful hardware requiring removal, the rate of major complications is less than 1 % in both open and arthroscopic hip preservation surgery. Thus, both open and arthroscopic hip preservation surgeries appear to be safe. Lack of clarity in reporting complications within orthopedic surgery has spurred academic hip surgeons to adapt and test a general surgery-validated complication reporting system for use in hip preservation.