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Effect of Postless Hip Arthroscopy on Functional Outcomes, Perineal Complications, and Lumbosacral Complications
Guanying Gao1,2,3, Yize Han1,2,3, Xiang Zhou1,2,3
1Department of Sports Medicine, Institute of Sports Medicine of Peking University, Peking University Third Hospital, Beijing, China.
Background:
Postless traction has been developed to avoid perineal post-related complications in hip arthroscopy. While it is reported to reduce groin-related issues, its effect on overall nerve injury rates, as well as potential new complications such as lumbosacral discomfort, remains unclear.
Hypothesis:
Postless traction may be linked to improved clinical outcomes but may carry an increased risk of lumbosacral discomfort.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
Patients who underwent postless hip arthroscopy were compared with matched patients who underwent conventional post-assisted traction. Patient-reported outcomes, including the Hip Outcome Score-Activities of Daily Living and Sports subscales (HOS-ADL and HOS-SS), the International Hip Outcome Tool-12 (iHOT-12), and the modified Harris Hip Score (mHHS), were collected via follow-up over a mean period of 476 days, ranging from 404 to 560 days. Complications including sensory deficits, perineal injury, and lumbosacral discomfort were also assessed.
Results:
A total of 32 patients who underwent postless hip arthroscopy were compared with 64 patients in the control group undergoing post-assisted traction. There was no significant difference in the overall rate of sensory nerve injury between the 2 groups (31.3% vs 32.8%; P = .88). No perineal soft tissue injuries occurred in the postless group, compared with 1 case (1.6%) in the control group (P > .05). However, the incidence of lumbosacral discomfort was significantly higher in the postless group (28.1% vs 6.3%; P = .008). The postless group showed significantly better scores on the HOS-SS (76.81 ± 21.07 vs 66.78 ± 21.30; P = .009) and iHOT-12 (80.57 ± 14.03 vs 65.65 ± 18.00; P < .001), while no differences were found in HOS-ADL or mHHS.
Conclusion:
Postless hip arthroscopy is associated with superior patient-reported functional outcomes. However, it shows no reduction in the overall rate of sensory nerve injury and is linked to a significantly higher risk of postoperative lumbosacral discomfort.
