Patient-specific factors influencing the traction forces in hip arthroscopy.
BACKGROUND
The application of traction in hip arthroscopy is associated with peri-operative complications. Within a therapeutic case series, patient-related factors correlating with high-traction forces during hip arthroscopy and occurring complications should be identified.


METHODS
In 30 male and 38 female patients (mean age: 44.5 years), intra-operative traction forces were monitored continuously using a specialised measurement device. A multivariate analysis was employed to identify patient-related factors influencing the traction force. Peri-operative complications (follow-up: 12 weeks) were evaluated by performing a single-case analysis.


RESULTS
The mean initial force prior to penetration of the capsule ("initial force") was 477 N (men: 517 N; women: 444 N), decreasing after capsulotomy by an average of 17 %. The male gender (p < 0.001), Kellgren and Lawrence radiographic stage (p = 0.037), low minimum joint-space width (p = 0.029) and high body height/weight (p = 0.003/0.037) correlated significantly with higher distraction forces. The patient age and type of anaesthesia (general versus spinal) were not relevant. Complications were observed in ten patients on the first post-operative day. In two of these patients a partial sensory deficit of the lateral cutaneous femoral nerve persisted after 12 weeks. All patients with complications required initial traction forces of >400 N.


CONCLUSIONS
The study revealed several patient-specific risk factors correlating with high-traction forces during hip arthroscopy. With view to potential complications, these patient groups require special attention during surgical treatment as well as in future studies.
Department of Orthopaedics, Rostock University Medical Center, Doberaner Strasse 142, 18057, Rostock, Germany. martin.ellenrieder@uni-rostock.de.
Martin
M
Ellenrieder
Department of Orthopaedics, Rostock University Medical Center, Doberaner Strasse 142, 18057, Rostock, Germany.
Thomas
T
Tischer
Department of Orthopaedics, Rostock University Medical Center, Doberaner Strasse 142, 18057, Rostock, Germany.
Rainer
R
Bader
Department of Orthopaedics, Rostock University Medical Center, Doberaner Strasse 142, 18057, Rostock, Germany.
Peter Cornelius
PC
Kreuz
Department of Orthopaedics, Rostock University Medical Center, Doberaner Strasse 142, 18057, Rostock, Germany.
Wolfram
W
Mittelmeier
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy / Q000009:adverse effects* / Q000379:methods; D001827:Body Height; D001835:Body Weight; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011859:Radiography; D012307:Risk Factors; D012737:Sex Factors; D014143:Traction / Q000009:adverse effects*; D055815:Young Adult
Complications; Force measurement; Hip arthroscopy; Hip joint distraction; Traction force