Effect of Postless Hip Arthroscopy on Functional Outcomes, Perineal Complications, and Lumbosacral Complications.

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.