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Factors associated with hip arthroscopy complications in the treatment of femoroacetabular impingement

BackgroundHip arthroscopy is performed with increasing frequency in the treatment of femoroacetabular impingement. This technique has a significant learning curve and requires special training. This study aimed to determine how preoperative and intraoperative factors and surgeon experience affect the incidence of complications. MethodsA prospective multicenter cohort study was conducted, which included 362 procedures in 360 patients undergoing hip arthroscopy for treatment of femoroacetabular impingement, with a minimum follow-up period of 6 mo. Complications were classified as minor if the patient's health or physical performance was not compromised, and as major if a patient's health or physical performance was affected or if reoperation was required. The group was divided in two chronologically: the learning curve group composed of the first 50 surgeries of each surgeon for a total of 150 hips in this group and the post-learning curve group, composed of the remaining 212 hips. ResultsMinor complications occured in 24.3% (88/362) and major complications in 1.1% (4/362). A positive association between the incidence of complications and learning curve (P<0.001) was found. Forty-four percent of the patients in group 1 had complications whereas only 12.7% in group 2. A positive association between traction time and minor complications was found. A traction time longer than 90 minutes increased the probability of sensitive neurological injury by a factor of 2.9 (RR 2.913; CI 95%; 1.875 - 4.526; P<0.001). ConclusionsHip arthroscopy is technically demanding and requires a learning curve to improve results. In our experience, the most frequently reported complication was transient neurological injury caused by prolonged traction times.