Post-Related Complications in Hip Arthroscopy Are Reported Significantly Greater in Prospective Versus Retrospective Literature: A Systematic Review

Austin E. Wininger, Omer Mei-Dan, Thomas J. Ellis, Brian D. Lewis, Robert C. Kollmorgen, Anthony Echo, Joshua D. Harris

Research output: Contribution to journalReview articlepeer-review

11 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)1658-1663
Number of pages6
JournalArthroscopy - Journal of Arthroscopic and Related Surgery
Issue number5
StatePublished - May 2022


  • Arthroscopy/adverse effects
  • Female
  • Femoracetabular Impingement/complications
  • Hip Joint/surgery
  • Humans
  • Male
  • Peripheral Nerve Injuries/epidemiology
  • Prospective Studies
  • Retrospective Studies
  • Traction/adverse effects

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine


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