Complications in hip Arthroscopy: Recognizing and managing adverse events

Hip arthroscopy has become an increasingly common and effective surgical technique for the diagnosis and treatment of various intra-articular hip disorders. While generally considered safe and minimally invasive, the procedure is not without risks. The increasing volume and complexity of hip arthroscopies has led to a rise in reported complications, highlighting the importance of understanding potential adverse events and their management. This Current Concepts Review aims to summarize the types, causes, and management strategies of complications associated with hip arthroscopy, emphasizing the importance of early recognition and evidence-based intervention to minimize morbidity based on the authors' experience and the available literature. Complications can be broadly categorized into neurovascular injuries, iatrogenic chondral and labral damage, fluid extravasation, deep vein thrombosis, and heterotopic ossification. Neuropraxia-particularly involving the pudendal and lateral femoral cutaneous nerves-is among the most common adverse events, often related to traction use and duration. Iatrogenic damage during portal placement or instrumentation is also significant, necessitating precise surgical technique and anatomical knowledge. Fluid extravasation, though rare, can result in abdominal compartment syndrome and requires prompt diagnosis. Effective management includes preventive measures such as appropriate patient positioning, limited traction time, and vigilant intraoperative monitoring. Though complications in hip arthroscopy are relatively uncommon, their potential impact necessitates a thorough understanding of risk factors, preventive strategies, and prompt intervention protocols. Improved surgical techniques, enhanced imaging modalities, and comprehensive training programs are essential for minimizing adverse outcomes and improving patient safety in hip arthroscopy.