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Femoroacetabular impingement: prospective study of rate and factors related for nerve injury after hip arthroscopy.

ABSTRACT: Prospective, longitudinal, descriptive study was conducted from January 2016 to January 2018 to detect nerve dysfunction after hip arthroscopy. A total of 110 patients were included. Twenty-four hours after surgery, 62.7% reported symptoms of abnormal sensation at least in one area. The most common was the perineal area. Three weeks after hip arthroscopy, 42.6% still experienced abnormal sensation. Six months after hip arthroscopy, only one patient remained with symptoms. Nerve dysfunction after HA was more common than has been reported in the literature within large populations. Traction time was a significant factor for the development of perineal nerve dysfunction.

SUBMITTER: Mas Martinez J

PROVIDER: S-EPMC6461587 | biostudies-literature | 2019 Sep-Oct

REPOSITORIES: biostudies-literature

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Femoroacetabular impingement: prospective study of rate and factors related for nerve injury after hip arthroscopy.

Mas Martinez Jesus J Sanz-Reig Javier J Morales Santias Manuel M Martínez Gimenez Enrique E Bustamante Suarez de Puga David D Verdu Román Carmen C

Journal of orthopaedics 20190408 5

Prospective, longitudinal, descriptive study was conducted from January 2016 to January 2018 to detect nerve dysfunction after hip arthroscopy. A total of 110 patients were included. Twenty-four hours after surgery, 62.7% reported symptoms of abnormal sensation at least in one area. The most common was the perineal area. Three weeks after hip arthroscopy, 42.6% still experienced abnormal sensation. Six months after hip arthroscopy, only one patient remained with symptoms. Nerve dysfunction after ...[more]

PMID: 31011246

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Project description:BackgroundFemoroacetabular impingement syndrome (FAIS) is most commonly diagnosed in athletes who sustain repetitive flexion and rotational loading to their hip. The purpose of this study was to evaluate a patient's ability to return to cycling after hip arthroscopy for FAIS.HypothesisThere is a high rate of return to cycling after hip arthroscopy.Study designRetrospective analysis.Level of evidenceLevel 4.MethodsConsecutive patients who had identified themselves as cyclists and had undergone hip arthroscopy for the treatment of FAIS were reviewed. Pre- and postoperative physical examinations, imaging, and patient-reported outcomes (PROs) scores, including the modified Harris Hip Score (mHHS), Hip Outcome Score Activities of Daily Living (HOS-ADL) and Sports-Specific (HOS-SS) subscales, and visual analog scale for pain, as well as a cycling-specific questionnaire, were assessed for all patients.ResultsA total of 58 patients (62% female; mean age, 30.0 ± 7.1 years; mean body mass index, 23.2 ± 2.7 kg/m2) were included. Prior to surgery, patients averaged 30 ± 42 miles per week (range, 2-300 miles). Fifty-five patients (95%) were forced to discontinue cycling at an average of 7.5 ± 6.2 months prior to surgery due to hip pain. Fifty-six patients (97%) returned to cycling at an average of 4.5 ± 2.5 months after surgery, with 33 (59%) returning to a better level of cycling and 23 (41%) to the same cycling level. Postoperatively, there was no difference in the average number of miles patients completed per week compared with preoperative values ( P = 0.08). At a mean follow-up of 31.14 ± 0.71 months (range, 24-48 months), all patients experienced significant improvements in mHHS, HOS-ADL, and HOS-SS PROs (all P < 0.0001), with an overall satisfaction rate of 91% ± 13%.ConclusionRecreational and competitive cyclists return to cycling 97% of the time after hip arthroscopy for FAIS, with most of these patients returning at an average of 4.5 months after surgery. This information is helpful in counseling patients on their expectations with regard to returning to cycling after hip arthroscopy for FAIS.Clinical relevanceCyclists return to sport 97% of the time at an average of 4.5 months after hip arthroscopy for FAIS.

Project description:PURPOSE:To provide estimates of postoperative opioid use after hip arthroscopy for femoroacetabular impingement (FAI) syndrome and to identify risk factors for increased postoperative opioid use. METHODS:All patients aged at least 18 years who were undergoing hip arthroscopy for FAI syndrome performed by 1 of 2 hip-preservation surgeons between November 2015 and August 2016 were eligible for inclusion in this study. Target minimum enrollment was set at 30 patients per surgeon based on an a priori sample size calculation. Enrolled patients completed the International Hip Outcome Tool, visual analog pain scale, Pain Catastrophizing Scale, abbreviated Patient Health Questionnaire, and questions regarding demographic characteristics and opioid and anti-inflammatory use. Opioid consumption was assessed through pill counting at 2- and 6-week postoperative appointments. Of 80 patients enrolled, 67 had complete 2- and 6-week opioid use data. Patient and operative factors were correlated with outcomes in multivariate models. RESULTS:Opioid use in the 2 weeks before surgery was significantly associated with higher postoperative opioid use at 2 weeks postoperatively (253.8 additional oral morphine equivalents [OMEs]; 95% confidence interval [CI], 171.2-336.5 additional OMEs; P < .0001; n = 73) and 6 weeks postoperatively (385.3 additional OMEs; 95% CI, 241.6-529.0 additional OMEs; P < .0001; n = 67). By 6 weeks postoperatively, 41 of 52 patients (79%) without opioid use in the 2 weeks before surgery used 30 or fewer 5-mg oxycodone pills compared with only 2 of 15 patients (13%) with preoperative use (odds ratio, 24.9; 95% CI, 4.2-148.5; P < .0001). CONCLUSIONS:Among patients undergoing hip arthroscopy for FAI syndrome, any opioid use in the 2 weeks preceding surgery was the strongest predictor of opioid use after hip arthroscopy. The impact of preoperative opioid use far exceeded the impact of other baseline patient and operative factors. Assessment of preoperative opioid use could be an important factor in guiding postoperative opioid prescribing. LEVEL OF EVIDENCE:Level II, prospective observational study.

Dataset Information

Femoroacetabular impingement: prospective study of rate and factors related for nerve injury after hip arthroscopy.

Publications

Femoroacetabular impingement: prospective study of rate and factors related for nerve injury after hip arthroscopy.

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