Abstract
Objectives:
Previous studies have demonstrated rates of groin-related nerve and/or soft-tissue complications as high as 46% following hip arthroscopy; however, the recent use of a postless hip distraction setup has shown promising reductions in these complications. A recent prospective study compared postoperative complications of patients undergoing hip arthroscopy with and without the use of a perineal post, with significantly fewer complications among patients undergoing postless hip arthroscopy. The purpose of this study was to prospectively compare the short-term clinical outcomes of patients undergoing hip arthroscopy with versus without the use of a perineal post.
Methods:
A prospective, single-surgeon cohort study was performed on all patients undergoing hip arthroscopy between January 2020 and March 2022. A post-free hip distraction system was used at one center at which the senior author operates, and a setup with a perineal post was used at another surgical location. An electronic survey of patient-reported outcome measures (PROMs) was completed by each patient at a minimum of 1 year postoperatively. PROMs included a visual analog scale (VAS) for pain, University of California Los Angeles (UCLA) Activity Scale, modified Harris Hip Score (mHHS), Hip Outcome Score-Sport (HOS-Sport), and a Single Assessment Numeric Evaluation (SANE).
Results:
Sixty patients were reached for follow-up (35 post, 25 patients postless). No differences were found between the post and postless groups in terms of age at surgery (34 ± 13 vs 30 ± 11 years, p = 0.18), sex (60% vs 56% female patients, p = 0.76), body mass index (26 ± 7 vs 24 ± 4, p = 0.25), or follow-up duration (23.5 ± 8 vs 20.8 ± 10 months, p = 0.25). There was a significantly higher VAS for pain (3.0 ± 2.6 vs 1.6 ± 1.6, p = 0.03) and lower UCLA Activity Score (6.9 ± 2.5 vs 8.2 ± 2.1, p = 0.04) in the post-assisted group. There were no significant differences between groups in other PROMs including mHHS (73.4 ± 16.7 vs 81.0 ± 12.5, p = 0.07), HOS-Sport (72.4 ± 26.1 vs 82.1 ± 25.8, p = 0.18), or SANE (78.6 ± 25.2 vs 87.6 ± 12.2, p = 0.13).
Conclusions:
Postless hip arthroscopy may result in an extended reduction in pain and perhaps higher activity levels compared to traditional post-assisted hip arthroscopy. Larger studies are warranted to corroborate these findings.