Complications of hip arthroscopy

Abstract

Hip arthroscopy is a relatively safe procedure with complications rates reported by several authors around 1.5%. As with any surgical procedure, there are potential complications related to bleeding, deep venous thrombosis, infection, and neurovascular injury. There are a number of complications related to hip arthroscopy that have not been reported in any other joint due to issues related to joint distraction, proximity to the abdomen, and treatment of hip-specific pathology. Most of the reported complications involve the use of traction and fluid management. However, the most frequent, but underreported, complications likely result from iatrogenic cartilage injury and over- or undertreatment of the underlying pathology. For example, inadequate resection of a CAM or pincer lesion for femoroacetabular impingement (FAI) may result in persistent pain or revision surgery, while overresection may cause subtle instability. As our understanding and ability to treat hip pathology have expanded, the rate of complications has not changed, but the types of complications have differed. In the early phases of hip arthroscopy, the complications were related to neurapraxias related to excessive traction time and limited to iatrogenic injury within the central compartment. Hip arthroscopy for FAI has also introduced complications that were not previously encountered. The goal of this chapter is to review potential complications related to hip arthroscopy and discuss strategies for avoiding them.