Purpose
To compare postoperative pain and early recovery after hip arthroscopy with and without
a perineal post for joint distraction.
Methods
We retrospectively reviewed a consecutive series of patients who underwent hip arthroscopy
before and after the adoption of a postless technique. Patients who underwent concurrent
periacetabular or femoral osteotomy were excluded. Demographic information, procedure
variables, and visual analog scale (VAS) pain scores were recorded. Analgesic medications
given were converted to morphine milligram equivalents (MME) for comparison. Uni-
and multivariate analyses were conducted to compare total MME, postoperative pain,
and time to discharge between groups.
Results
One hundred patients were in each group. The overall age (mean ± standard deviation)
was 26.5 ± 9.9 years (Post [P]: 57 females; No Post [NP]: 68 females). Total operative
time (P 100.4 ± 17.9 minutes vs NP 89.1 ± 25.5 minutes, P = .0004), traction time (P 45.8 ± 10.3 minutes vs NP 40.9 ± 11.1 minutes, P = .0017), and operating room time (P 148.8 ± 19.3 minutes vs NP 137.3 ± 25.8 minutes,
P = .0005) were found to be shorter in the NP group. Total MME, and final VAS pain
scores in the PACU were similar between both groups (MME, P = .1620; VAS, P = .2139). Time to discharge was significantly shorter in the NP group (P 207.2 ±
58.8 vs NP 167.5 ± 47.9, P < .0001). Patient age (≥25 years) (65.2 ± 18.1 vs 59.8 ± 15.7 [MME], P = .0269) and elevated body mass index (≥25) (65.1 ± 17.1 vs 59.3 ± 16.4 [MME], P = .0164) were factors associated with greater total MME consumption. Female sex was
associated with higher postoperative VAS pain scores (FM 4.1 ± 1.6 vs M 3.4 ± 1.8
P = .0027).
Conclusions
Adoption of the postless technique did not result in prolonged operating room or operative
time. Overall, both groups had similar postoperative pain, however, the time from
surgery to hospital discharge was shorter in the postless group.
Level of Evidence
III, retrospective comparison study.
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Article info
Publication history
Published online: March 31, 2021
Accepted:
March 17,
2021
Received:
September 30,
2020
Footnotes
See commentary on page 2846
The authors report the following potential conflicts of interest or sources of funding: M.C.W. reports other from Biomet, outside the submitted work. R.W.W. reports other from Arthroscopy, the American Journal of Sports Medicine, the American Orthopaedic Society for Sports Medicine, and CONMED Linvatec; and nonfinancial support from Smith & Nephew, outside the submitted work. Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1TR002537. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2021 Published by Elsevier on behalf of the Arthroscopy Association of North America
