Purpose
To determine the prevalence of complications and reoperations during and after hip
arthroscopy.
Methods
A systematic review of multiple medical databases was performed using the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and checklist.
All clinical outcome studies that reported the presence or absence of complications
and/or reoperations were eligible for inclusion. Length of follow-up was not an exclusion
criterion. Complication and reoperation rates were extracted from each study. Duplicate
patient populations within separate distinct publications were analyzed and reported
only once.
Results
Ninety-two studies (6,134 participants) were included. Most were Level IV evidence
studies (88%) with short-term follow-up (mean 2.0 years). Labral tears and femoroacetabular
impingement (FAI) were the 2 most common diagnoses treated, and labral treatment and
acetabuloplasty/femoral osteochondroplasty were the 2 most common surgical techniques
reported. Overall, major and minor complication rates were 0.58% and 7.5%, respectively.
Iatrogenic chondrolabral injury and temporary neuropraxia were the 2 most common minor
complications. The overall reoperation rate was 6.3%, occurring at a mean of 16 months.
Total hip arthroplasty (THA) was the most common reoperation. The conversion rate
to THA was 2.9%.
Conclusions
The rate of major complications was 0.58% after hip arthroscopy. The reoperation rate
was 6.3%, and the most common reason for reoperation was conversion to THA. Minor
complications and the reoperation rate are directly related to the learning curve
of hip arthroscopy. As surgical indications evolve, patient selection should limit
the number of cases that would have been converted to THA. Similarly, the number of
minor complications is directly related to technical aspects of the procedure and
therefore will decrease with surgeon experience and improvement in instrumentation.
Level of Evidence
Level IV, a systematic review of Level I to IV studies.
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Article info
Publication history
Accepted:
November 1,
2012
Received:
October 22,
2012
Footnotes
The authors report the following potential conflict of interest or source of funding in relation to this article: T.J.E. is a paid consultant for Stryker and Smith & Nephew, receives research support from Stryker, and receives royalties from Acute Innovations. C.B.J. is an unpaid consultant for The Foundry. S.J.N. is a paid consultant for Stryker, Pivot Medical, and Ossur and receives research support from Arthrex, Linvatec, Smith & Nephew, DJ Orthopaedics, Miomed, Athletico, Stryker, Pivot Medical, and Allosource. J.D.H., A.K.G., G.D.A., F.M.M., and B.R.B. report that they have no conflicts of interest in the authorship and publication of this article.
Identification
Copyright
© 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
