Pudendal nerve neuralgia after hip arthroscopy: retrospective study and literature review.
BACKGROUND
Pudendal nerve neurapraxia is a classic complication after traction on the fracture table. Diagnosis, however, is difficult and often overlooked, especially after arthroscopy in traction on fracture table; incidence is therefore not known exactly.


OBJECTIVE
The study hypothesis was that incidence of pudendal nerve neuropathy exceeds 1% after hip arthroscopy.


METHODS
Results for 150 patients (79 female, 71 male) undergoing hip arthroscopy between 2000 and 2010 were analyzed retrospectively. The principal assessment criterion was onset of pudendal neuralgia. Secondary criteria were risk factors (history, surgery time, type of anesthesia), associated complications, onset to diagnosis interval and pattern of evolution.


RESULTS
At a mean 93 months' follow-up, there were 3 cases (2 women, 1 man) (2%) of pure sensory pudendal neuralgia; 2 concerned labral lesion resection and 1 osteochondromatosis. Surgery time ranged from 60 to 120min, under general anesthesia with curarization. Time to diagnosis was 3 weeks. No complementary examinations were performed. Spontaneous resolution occurred at 3 weeks to 6 months. No significant risk factors emerged.


CONCLUSIONS
The present study found 2% incidence of pudendal neuralgia, with no risk factors emerging from analysis. Prevention involves limiting traction force and duration by using a large pelvic support (diameter>8-10cm). Patient information and postoperative screening should be systematic.


METHODS
Level IV. Retrospective study.
Service de chirurgie orthopédique, hôpital Rangueil, 1, avenue du Pr-Jean-Poulhès, TSA 50032, 31059 Toulouse cedex, France. Electronic address: regis.pailhe@doctors.org.uk.
R
R
Pailhé
P
P
Chiron
N
N
Reina
E
E
Cavaignac
V
V
Lafontan
J-M
JM
Laffosse
D001182:Arthroscopy / Q000009:adverse effects*; D014943:Global Health; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D015994:Incidence; D059348:Peripheral Nerve Injuries / Q000150:complications / Q000175:diagnosis; D011183:Postoperative Complications; D060525:Pudendal Nerve / Q000293:injuries*; D060545:Pudendal Neuralgia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies
Complication; Fracture table; Hip arthroscopy; Neurapraxia; Pudendal nerve