Hip arthroscopy for femoroacetabular impingement: the changing nature and severity of associated complications over time.
OBJECTIVE
The aim of this study was to assess complications related to arthroscopy for femoroacetabular impingement (FAI) and how these complications have changed as we have gained more experience with this procedure.


METHODS
The authors reviewed 200 hips (197 patients). The average patient age was 44.64 years and the mean follow-up time was 28.2 months. All patients underwent hip arthroscopy in the supine position. Clinically, Modified Harris Hip Scores (MHHS) and patient satisfaction with outcome were used. We divided complications into 3 groups: Group 1 related to traction, group 2 related to surgical technique or implant failure, and group 3 related to outcomes.


RESULTS
Clinically, the MHHS improved from 69.96 (±6.10) to 80.45 (±7.00), and patient satisfaction with the achieved outcome increased to 8.87 (±0.76). The overall complication rate was 15% (30 of 200 hips). Group 1 consisted of 4 patients with pudendal neuropraxia and 2 patients with ankle joint pain (P = .013). Group 2 consisted of 2 patients with lateral femoral cutaneous neuropraxia, 2 patients with iatrogenic labral perforations, one patient with a labral tear, and 4 patients with femoral head scuffs. There were 4 incidents of instrument breakage. Furthermore, 3 suture anchors failed, a second-degree burn occurred in one patient, and there was incomplete reshaping in 5 hips (P = .045). Group 3 included one patient with a snapping sound and heterotopic ossification. Second-look arthroscopy was performed for 5 hips. All the complications outlined in groups 1 and 2 are related to the learning curve and have statistical significance (P < .05).


CONCLUSIONS
Complications relating to hip arthroscopy took different forms during the early learning period, but overall complication rates decreased along the learning curve. Surgical technique-related complications such as problems with suture anchors and the reshaping of cam impingements were also considered during the later stage.


METHODS
Level IV, therapeutic case series.
Department of Orthopedic Surgery, Chonbuk National University Hospital, Research Institute of Clinical Medicine, Jeonju, Korea. Electronic address: mspark@jbnu.ac.kr.
Myung-Sik
MS
Park
Department of Orthopedic Surgery, Chonbuk National University Hospital, Research Institute of Clinical Medicine, Jeonju, Korea.
Sun-Jung
SJ
Yoon
Department of Orthopedic Surgery, Chonbuk National University Hospital, Research Institute of Clinical Medicine, Jeonju, Korea.
Yong-Jin
YJ
Kim
Department of Orthopedic Surgery, Carollo Hospital, Sunchun, Korea.
Woo-Chul
WC
Chung
D000293:Adolescent; D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000009:adverse effects*; D005260:Female; D057925:Femoracetabular Impingement / Q000601:surgery*; D006801:Humans; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000145:classification; D012189:Retrospective Studies; D055815:Young Adult