Prospective study of nerve injuries associated with hip arthroscopy in the lateral position using the modified portals

Abstract

To access the central compartment of the hip, distraction is essential in hip arthroscopy (HA); nerve injuries have long been accepted as a complication of this surgical procedure, with an incidence ranging from 0 to 46%. Only one previous article collected data prospectively, and the authors utilized a supine technique, with a modified mid-anterior portal. Our study also used prospectively collected data, from a group of 200 consecutive patients who had HA performed in the lateral position using the paratrochanteric portals. Our results were that four patients (2%) reported symptoms of neurological deficits after surgery, three patients with traction times ranging from 20 to 41 min, their neurological deficits resolved completely over a time from 6 to 9 weeks. The fourth patient who had the longest traction time of 73 min, and also greater than usual traction, his neurological deficit resolved at 12 weeks. Our hypothesis of 200 hip arthroscopies, performed in the lateral position by the modified paratrochanteric portals, the incidence of nerve injuries would be lower than 46%. We found an incidence of 2%, all affecting the perineum and genitals and all occurring in men, no differences between the age, surgery side or type of surgery performed on the patient were found to have statistical differences. Traction times with <31.5 min were related with fewer incidences of neurological symptoms. On the basis of this study, all patients with traction times below 73 min can be confidently reassured that any deficit will recover within 3 months.