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Fluid Extravasation in Hip Arthroscopy: A Systematic Review.
Seper Ekhtiari1, Chloe E Haldane1, Darren de Sa2
1Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
Summary
Fluid extravasation during hip arthroscopy is a rare but serious complication. Prompt recognition and management, often surgical or via paracentesis, are crucial for patient recovery.
Area of Science:
- Orthopedic surgery
- Minimally invasive procedures
- Surgical complications
Background:
- Fluid extravasation is a recognized complication in arthroscopic surgery.
- Hip arthroscopy involves the use of distension fluid, increasing the risk of extravasation.
- Understanding the incidence and characteristics of this complication is vital for patient safety.
Purpose of the Study:
- To characterize fluid extravasation during hip arthroscopy.
- To identify common factors associated with fluid extravasation.
- To describe management strategies and outcomes for this complication.
Main Methods:
- Systematic review of MEDLINE, EMBASE, and PubMed databases.
- Duplicate screening and data collection on patient demographics, fluid management, presentation, management, and outcomes.
- Quality assessment using the Methodological Index for Non-Randomized Studies Criteria.
Main Results:
- 1.6% of patients (21/1286) experienced symptomatic fluid extravasation.
- Common signs included abdominal distension (89%), hypothermia (56%), hypotension, and metabolic acidosis (33%).
- Most patients required intervention (surgery or paracentesis), with all stabilizing and discharging, though one had persistent complaints.
Conclusions:
- Fluid extravasation is a rare but potentially life-threatening hip arthroscopy complication.
- Early recognition and prompt management by surgeons and anesthesiologists are essential.
- While some cases resolve with conservative management, most necessitate interventional treatment.
