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Postless hip distraction systems decrease the amount of traction force needed to obtain adequate hip distraction versus a conventional post hip distractor

Published:October 22, 2022DOI:https://doi.org/10.1016/j.arthro.2022.10.009

      Abstract

      Purpose

      The purpose of this study was to directly compare hip distraction distance and traction force data for hip arthroscopy performed using a post-based versus a postless system.

      Methods

      Adult patients undergoing primary hip arthroscopy for femoroacetabular impingement were prospectively enrolled. Arthroscopy performed before March 26th, 2019 was performed using a post-based system. After this date, the senior author converted to a postless system. Intra-operative traction force and fluoroscopic distraction distance were measured to calculate hip stiffness coefficients at holding traction (k-hold) and maximal traction (k-max). Multivariable regression analysis was used to determine whether postless arthroscopy was predictive of lower stiffness coefficients while controlling for other relevant patient specific factors.

      Results

      105 patients underwent hip arthroscopy with a post-based system and 51 patients underwent the procedure with a postless system. Mean holding traction force (67.5 ± 14.0 vs. 55.8 ± 15.3 kgf) and mean maximum traction force (96.0 ± 16.6 vs. 69.9 ± 14.1 kgf) were significantly lower in the postless group. In a multivariable analysis, postless traction was an independent predictor of decreased k-hold (ß = -31.4; 95% CI[-61.2, -1.6]) and of decreased k-max (ß = -90.4, 95% CI[-127.8, -53.1]). Male gender, Beighton score = 0, and poor hamstring flexibility were also predictors of increased k-hold and k-max in the multivariable model.

      Conclusion

      Postless traction systems decrease the amount of traction force required for adequate hip distraction for both maximal and holding traction forces when compared to post-based systems. Postless traction systems may help further reduce distraction-type neurologic injuries and pain following hip arthroscopy by lowering the traction force required to safely distract the hip.

      Level of Evidence

      Prospective cohort, historical control comparative study, Level III

      Key Terms

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