Division of Sports Medicine, Children's Hospital Boston, Massachusetts, USA.
Arthroscopy. 2012 Nov;28(11):1654-1660.e2. doi: 10.1016/j.arthro.2012.04.151. Epub 2012 Sep 16.
The purpose of this study was to survey experts in the field of hip arthroscopy from the Multicenter Arthroscopy of the Hip Outcomes Research Network (MAHORN) group to determine the frequency of symptomatic intra-abdominal fluid extravasation (IAFE) after arthroscopic hip procedures, identify potential risk factors, and develop preventative measures and treatment strategies in the event of symptomatic IAFE.
A survey was sent to all members of the MAHORN group. Surveys collected data on general hip arthroscopy settings, including pump pressure and frequency of different hip arthroscopies performed, as well as details on cases of symptomatic IAFE. Responses to the survey were documented and analyzed.
Fifteen hip arthroscopists from the MAHORN group were surveyed. A total of 25,648 hip arthroscopies between 1984 and 2010 were reviewed. Arthroscopic procedures included capsulotomies, labral reattachment after acetabuloplasty, peripheral compartment arthroscopy, and osteoplasty of the femoral head-neck junction. Of the arthroscopists, 7 (47%) had 1 or more cases of IAFE (40 cases reported). The prevalence of IAFE in this study was 0.16% (40 of 25,650). Significant risk factors associated with IAFE were higher arthroscopic fluid pump pressure (P = .004) and concomitant iliopsoas tenotomy (P < .001). In all 40 cases, the condition was successfully treated without long-term sequelae. Treatment options included observation, intravenous furosemide, and Foley catheter placement, as well as 1 case of laparotomy.
Symptomatic IAFE after hip arthroscopy is a rare occurrence, with an approximate prevalence of 0.16%. Prevention of IAFE should include close intraoperative and postoperative monitoring of abdominal distention, core body temperature, and hemodynamic stability. Concomitant iliopsoas tenotomy and high pump pressures may be risk factors leading to symptomatic IAFE.
Level IV, therapeutic case series.
本研究旨在调查髋关节镜手术多中心研究网络（MAHORN）组的髋关节镜领域专家，以确定髋关节镜手术后出现症状性腹腔内液体外渗（IAFE）的频率，确定潜在的危险因素，并在出现症状性 IAFE 时制定预防措施和治疗策略。
向 MAHORN 组的所有成员发送了一份调查问卷。调查收集了一般髋关节镜设置的数据，包括泵压和不同髋关节镜手术的频率，以及症状性 IAFE 病例的详细信息。记录并分析了对调查的答复。
对 MAHORN 组的 15 名髋关节镜专家进行了调查。共回顾了 1984 年至 2010 年期间的 25648 例髋关节镜手术。关节镜手术包括囊切开术、髋臼成形术后盂唇再附着、外周隔室关节镜检查和股骨头颈交界处骨成形术。在这些关节镜专家中，有 7 人（47%）有 1 例或多例 IAFE（报告了 40 例）。本研究中 IAFE 的患病率为 0.16%（25650 例中有 40 例）。与 IAFE 相关的显著危险因素包括较高的关节镜液泵压（P=0.004）和同时进行的髂腰肌切开术（P<0.001）。在所有 40 例中，均成功治疗而无长期后遗症。治疗选择包括观察、静脉注射速尿和 Foley 导管放置，以及 1 例剖腹手术。
髋关节镜术后出现症状性 IAFE 较为罕见，其患病率约为 0.16%。IAFE 的预防应包括密切监测术中及术后腹部膨隆、核心体温和血流动力学稳定性。同时进行的髂腰肌切开术和高泵压可能是导致症状性 IAFE 的危险因素。
IV 级，治疗性病例系列研究。
