Fluid Extravasation Related to Hip Arthroscopy: A Prospective Computed Tomography-Based Study

Area of Science:

• Orthopedic Surgery
• Minimally Invasive Procedures

Background:

• Hip arthroscopy complications are rare (<2%), but fluid extravasation can lead to serious conditions like abdominal compartment syndrome.
• Understanding fluid extravasation is crucial for patient safety during hip arthroscopy.

Purpose of the Study:

• Identify risk factors for fluid extravasation during hip arthroscopy.
• Correlate anatomical locations identified by CT scans with the volume of extravasated fluid.

Main Methods:

• Prospective cohort study of 40 femoroacetabular impingement hip arthroscopies.
• Recorded patient demographics and surgical procedures (acetabuloplasty, femoral osteoplasty, psoas tenotomy).
• Estimated extravasated volume and used CT scans for a 3-stage radiological classification of fluid spread.

Main Results:

• Mean extravasated volume was 3.06 L (approx. 10% of infused volume) without significant clinical symptoms.
• A trend towards increased extravasation with longer operative times and peripheral compartment work (without traction) was observed.
• CT classification showed direct correlation with extravasated volume, involving thigh, gluteus, and retroperitoneal/intraperitoneal spaces; females had a 6-fold higher risk of advanced extravasation.

Conclusions:

• Approximately 10% of infused fluid was extravasated in uncomplicated hip arthroscopy cases.
• Operative time and peripheral compartment intervention without traction are risk factors for fluid extravasation.
• The proposed CT-based anatomical classification effectively illustrates progressive fluid spread, with females exhibiting more severe compromise.