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

Nossa, Juan M.a; Aguilera, Berardob; Márquez, Williamc; Aranzazu, Andrésc; Alzate, Ricardoc; Rueda, Guillermod; Márquez, Diego J.e; Escobar, Nathalia A.; Acuña, Jose

doi: 10.1097/BCO.0000000000000122

Background Hip 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.

Methods A 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.

Results Minor 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).

Conclusions Hip 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.

aFundación Universitaria de Ciencias de la Salud – FUCS. Calle 10 # 18–75. Bogotá D. C. Colombia

bCentro Médico IMBANACO, Cali, Colombia

cClínica de las Américas, Medellín

dHospital de San José, Bogotá Colombia

eClínica del Country, Bogotá Colombia

Financial Disclosure: The authors report no conflicts of interest.

Correspondence to Juan M. Nossa, MD, Calle 97 #23–37 Of. 515., Bogotá D. C, Colombia Tel: 57 (1) 6421363 – 6421367; fax: 57 1 6421367; e-mail:

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins