title: Intra-abdominal fluid extravasation during hip arthroscopy: a survey of the MAHORN group.
abstract: OBJECTIVE
  The purpose of this study was to survey experts in the field of hip arthroscopy from the Multicenter Arthroscopy of the Hip Outcomes Research Network (MAHORN) group to determine the frequency of symptomatic intra-abdominal fluid extravasation (IAFE) after arthroscopic hip procedures, identify potential risk factors, and develop preventative measures and treatment strategies in the event of symptomatic IAFE.
  
  
  METHODS
  A survey was sent to all members of the MAHORN group. Surveys collected data on general hip arthroscopy settings, including pump pressure and frequency of different hip arthroscopies performed, as well as details on cases of symptomatic IAFE. Responses to the survey were documented and analyzed.
  
  
  RESULTS
  Fifteen hip arthroscopists from the MAHORN group were surveyed. A total of 25,648 hip arthroscopies between 1984 and 2010 were reviewed. Arthroscopic procedures included capsulotomies, labral reattachment after acetabuloplasty, peripheral compartment arthroscopy, and osteoplasty of the femoral head-neck junction. Of the arthroscopists, 7 (47%) had 1 or more cases of IAFE (40 cases reported). The prevalence of IAFE in this study was 0.16% (40 of 25,650). Significant risk factors associated with IAFE were higher arthroscopic fluid pump pressure (P = .004) and concomitant iliopsoas tenotomy (P < .001). In all 40 cases, the condition was successfully treated without long-term sequelae. Treatment options included observation, intravenous furosemide, and Foley catheter placement, as well as 1 case of laparotomy.
  
  
  CONCLUSIONS
  Symptomatic IAFE after hip arthroscopy is a rare occurrence, with an approximate prevalence of 0.16%. Prevention of IAFE should include close intraoperative and postoperative monitoring of abdominal distention, core body temperature, and hemodynamic stability. Concomitant iliopsoas tenotomy and high pump pressures may be risk factors leading to symptomatic IAFE.
  
  
  METHODS
  Level IV, therapeutic case series.
authors.affiliation: Division of Sports Medicine, Children's Hospital Boston, Massachusetts, USA. mininder.kocher@childrens.harvard.edu
authors.forename: Mininder S
authors.initials: MS
authors.lastname: Kocher
authors.forename: Jeremy S
authors.initials: JS
authors.lastname: Frank
authors.forename: Adam Y
authors.initials: AY
authors.lastname: Nasreddine
authors.forename: Marc R
authors.initials: MR
authors.lastname: Safran
authors.forename: Marc J
authors.initials: MJ
authors.lastname: Philippon
authors.forename: Jon K
authors.initials: JK
authors.lastname: Sekiya
authors.forename: Bryan T
authors.initials: BT
authors.lastname: Kelly
authors.forename: J W Thomas
authors.initials: JW
authors.lastname: Byrd
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Guanche
authors.forename: Hal D
authors.initials: HD
authors.lastname: Martin
authors.forename: John C
authors.initials: JC
authors.lastname: Clohisy
authors.forename: Nick G
authors.initials: NG
authors.lastname: Mohtadi
authors.forename: Damian R
authors.initials: DR
authors.lastname: Griffin
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Sampson
authors.forename: Michael
authors.initials: M
authors.lastname: Leunig
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Larson
authors.forename: Victor M
authors.initials: VM
authors.lastname: Ilizaliturri
authors.forename: Joseph C
authors.initials: JC
authors.lastname: McCarthy
authors.forename: Peter G
authors.initials: PG
authors.lastname: Gambacorta
mesh_terms: D015746:Abdominal Pain / Q000453:epidemiology* / Q000209:etiology; D000077:Acetabulum / Q000601:surgery; D001182:Arthroscopy / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data*; D001201:Ascites / Q000453:epidemiology / Q000209:etiology; D002358:Cartilage, Articular / Q000601:surgery; D015984:Causality; D004322:Drainage / Q000706:statistics & numerical data; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000453:epidemiology* / Q000209:etiology; D006617:Hip Dislocation / Q000150:complications / Q000601:surgery*; D006620:Hip Fractures / Q000150:complications / Q000601:surgery*; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D059325:Intra-Abdominal Hypertension / Q000453:epidemiology / Q000209:etiology; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires