TY - JOUR
T1 - Post-Related Complications in Hip Arthroscopy Are Reported Significantly Greater in Prospective Versus Retrospective Literature
T2 - A Systematic Review
AU - Wininger, Austin E.
AU - Mei-Dan, Omer
AU - Ellis, Thomas J.
AU - Lewis, Brian D.
AU - Kollmorgen, Robert C.
AU - Echo, Anthony
AU - Harris, Joshua D.
N1 - Funding Information:
The authors report the following potential conflicts of interest or sources of funding: O.M.D. reports stock or stock options from MITA and IP royalties, and research support from Stryker. T.J.E. reports IP royalties from Acute Innovations; educational support from Arthrex; and paid consultant, research support from Medacta. B.D.L. reports paid consultant for Stryker and Zimmer. R.C.K. reports editorial or governing board for Arthroscopy, and paid consultant for Xodus Medical. A.E. reports paid consultant for Axogen and paid presenter or speaker for Checkpoint Surgical, Inc. J.D.H. reports board or committee member for AAOS and American Orthopaedic Society for Sports Medicine; editorial or governing board for Arthroscopy; board or committee member for AANA; research support from DePuy, A Johnson & Johnson Company; board or committee member of International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine; stock or stock options from PatientPop; publishing royalties, financial, or material support from SLACK Inc.; paid consultant, paid presenter or speaker, research support Smith & Nephew; and paid presenter or speaker Xodus Medical. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Publisher Copyright:
© 2021 Arthroscopy Association of North America
PY - 2022/5
Y1 - 2022/5
N2 - PURPOSE: To determine whether there are differences in (1) the incidence of post-related complications following hip arthroscopy between prospective and retrospective publications; and (2) between post-assisted and postless techniques.METHODS: A systematic review was performed using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to characterize post-related complications following hip arthroscopy for central or peripheral compartment hip pathology, including femoroacetabular impingement syndrome and chondrolabral injury. Inclusion criteria were prospective and retrospective Level I-IV evidence investigations that reported results of hip arthroscopy performed in the supine position. Exclusion criteria included open or extra-articular endoscopic hip surgery. Post-related complications included pudendal nerve injury (sexual dysfunction, dyspareunia, perineal pain or numbness) or perineum/external genitalia soft-tissue injury.RESULTS: Ninety-four studies (12,212 hips; 49% male, 51% female; 52% Level IV evidence) were analyzed. Prospective studies (3,032 hips) report a greater incidence of post-related complications compared with retrospective (8,116 hips) studies (7.1% vs 1.4%, P < .001). Three studies (1,064 hips) used a postless technique and all reported a 0% incidence of pudendal neurapraxia or perineal soft tissue injury. Most pudendal nerve complications were transient, resolving by 3 months, but permanent nerve injury was reported in 4 cases. Only 19%, 22%, 7%, and 4% of studies reported a total surgery time, traction time, traction force, and bed Trendelenburg angle for their study samples, respectively.CONCLUSIONS: The incidence of post-related complications is 5 times greater in prospective (versus retrospective) hip arthroscopy literature. Postless distraction resulted in a 0% incidence of post-related injuries.LEVEL OF EVIDENCE: IV, systematic review of Level I-IV evidence.
AB - PURPOSE: To determine whether there are differences in (1) the incidence of post-related complications following hip arthroscopy between prospective and retrospective publications; and (2) between post-assisted and postless techniques.METHODS: A systematic review was performed using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to characterize post-related complications following hip arthroscopy for central or peripheral compartment hip pathology, including femoroacetabular impingement syndrome and chondrolabral injury. Inclusion criteria were prospective and retrospective Level I-IV evidence investigations that reported results of hip arthroscopy performed in the supine position. Exclusion criteria included open or extra-articular endoscopic hip surgery. Post-related complications included pudendal nerve injury (sexual dysfunction, dyspareunia, perineal pain or numbness) or perineum/external genitalia soft-tissue injury.RESULTS: Ninety-four studies (12,212 hips; 49% male, 51% female; 52% Level IV evidence) were analyzed. Prospective studies (3,032 hips) report a greater incidence of post-related complications compared with retrospective (8,116 hips) studies (7.1% vs 1.4%, P < .001). Three studies (1,064 hips) used a postless technique and all reported a 0% incidence of pudendal neurapraxia or perineal soft tissue injury. Most pudendal nerve complications were transient, resolving by 3 months, but permanent nerve injury was reported in 4 cases. Only 19%, 22%, 7%, and 4% of studies reported a total surgery time, traction time, traction force, and bed Trendelenburg angle for their study samples, respectively.CONCLUSIONS: The incidence of post-related complications is 5 times greater in prospective (versus retrospective) hip arthroscopy literature. Postless distraction resulted in a 0% incidence of post-related injuries.LEVEL OF EVIDENCE: IV, systematic review of Level I-IV evidence.
KW - Arthroscopy/adverse effects
KW - Female
KW - Femoracetabular Impingement/complications
KW - Hip Joint/surgery
KW - Humans
KW - Male
KW - Peripheral Nerve Injuries/epidemiology
KW - Prospective Studies
KW - Retrospective Studies
KW - Traction/adverse effects
UR - http://www.scopus.com/inward/record.url?scp=85122045115&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85122045115&partnerID=8YFLogxK
U2 - 10.1016/j.arthro.2021.11.045
DO - 10.1016/j.arthro.2021.11.045
M3 - Review article
C2 - 34883199
AN - SCOPUS:85122045115
SN - 0749-8063
VL - 38
SP - 1658
EP - 1663
JO - Arthroscopy - Journal of Arthroscopic and Related Surgery
JF - Arthroscopy - Journal of Arthroscopic and Related Surgery
IS - 5
ER -