Department of Orthopedic Surgery, University of Utah, Salt Lake City, Utah, USA.
UNC Health-Cary Orthopaedic and Sports Medicine Specialists, Cary, North Carolina, USA.
Am J Sports Med. 2023 Nov;51(13):3447-3453. doi: 10.1177/03635465231201607. Epub 2023 Oct 16.
Patients undergoing hip arthroscopy performed with perineal post distraction may experience postoperative nerve and soft tissue complications related to the perineal post.
To compare rates of postoperative numbness in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS) with postless distraction and perineal post distraction methods.
Cohort study; Level of evidence, 3.
A retrospective review of prospectively collected data was performed on patients who underwent hip arthroscopy for FAIS, with postless distraction and perineal post distraction methods. Medical records were reviewed for patient characteristics, radiographic data, and operative data. Traction force data were collected on all patients prospectively using a previously validated method. Data on postoperative numbness (presence/absence and regionality) were collected prospectively at routine postoperative follow-ups (6-week and 3-month postoperative clinic visits).
Overall, 195 patients were included, with 94 patients (mean age, 30.4 years) in the postless distraction cohort and 101 patients (mean age, 31.9 years) in the post distraction cohort. The overall numbness rates were 29 of 94 (30.9%) in the postless distraction group and 45 of 101 (44.6%) in the post distraction group ( = .068). Rates of postoperative groin numbness were 1 of 94 (1.1%) in the postless distraction group and 19 of 101 (18.8%) in the post distraction group ( < .001). Multivariate analysis for postoperative groin numbness demonstrated post distraction (odds ratio [OR], 16.5; = .022) and traction time (OR, 1.7; = .020) to be statistically significant variables. In subgroup analysis of the post distraction group, traction time ( = .015), but not holding ( = .508) or maximum traction force ( = .665), reached statistical significance in patients who developed postoperative groin numbness.
Postless distraction hip arthroscopy demonstrated a statistically significantly lower rate of groin numbness rates in comparison with a traditional perineal post distraction method. In the post distraction group, traction time was significantly higher in patients who developed postoperative groin numbness than in those who did not.
接受会阴后牵开的髋关节镜检查的患者可能会出现与会阴后牵开器相关的术后神经和软组织并发症。
比较股骨髋臼撞击综合征 (FAIS) 髋关节镜检查中使用无后牵开器和会阴后牵开器方法的患者术后麻木的发生率。
队列研究；证据水平，3 级。
对接受 FAIS 髋关节镜检查的患者进行前瞻性收集数据的回顾性分析，采用无后牵开器和会阴后牵开器方法。回顾病历以获取患者特征、影像学数据和手术数据。使用先前验证的方法前瞻性收集所有患者的牵引力数据。使用前瞻性方法在常规术后随访（术后 6 周和 3 个月的门诊就诊）中收集术后麻木（存在/不存在和区域性）的数据。
共有 195 例患者入组，无后牵开器组 94 例（平均年龄 30.4 岁），后牵开器组 101 例（平均年龄 31.9 岁）。无后牵开器组总体麻木率为 29/94（30.9%），后牵开器组为 45/101（44.6%）（=.068）。术后腹股沟麻木发生率在后牵开器组为 1/94（1.1%），在后牵开器组为 19/101（18.8%）（<.001）。术后腹股沟麻木的多变量分析表明后牵开器（优势比 [OR]，16.5；=.022）和牵引时间（OR，1.7；=.020）为统计学显著变量。在后牵开器组的亚组分析中，牵引时间（=.015），而不是保持（=.508）或最大牵引力（=.665），在出现术后腹股沟麻木的患者中具有统计学意义。
与传统的会阴后牵开器方法相比，无后牵开器髋关节镜检查显示腹股沟麻木发生率具有统计学显著降低。在后牵开器组中，出现术后腹股沟麻木的患者的牵引时间明显高于未出现的患者。
