Hip arthroscopy in trauma: a systematic review of the indications, effectiveness and complications

A recently published study in the American journal “Arthroscopy” carried out a systematic review in order to investigate the indications, the effectiveness and the complications of hip arthroscopy in the setting of acute trauma.
The PubMed, Medline, Embase and Web of Science databases were searched, from March 2015, for studies reporting hip arthroscopy in the treatment of trauma. The inclusion criteria covered arthroscopic management of traumatic injuries of the hip.
From an initial search of 2,809 studies, 32 studies met the inclusion criteria. A total of 144 patients underwent hip arthroscopy for six trauma-related indications: eight for removal of a bullet (war injury), six for fixation of a femoral head fracture, 82 for removal of loose bodies, six for fixation of an acetabular fracture, 20 for repair of a tear of the labrum and 23 for debridement of the ligamentum teres. The patients were followed up postoperatively for a mean of 2.9 years. A successful operation was achieved in 96% of patients. The rate of major complications (pulmonary embolism and abdominal compartment syndrome) was 1.4%, while avascular necrosis of the femoral head was 1.4% and nerve palsy 0.7%.
The authors concluded that hip arthroscopy appears to be effective and safe in the setting of trauma. These data should be interpreted with caution, because of the low quality of the evidence in the studies included. Surgeons should be aware of the potential complications, such as abdominal compartment syndrome and thromboembolic events, when performing hip arthroscopy in the setting of trauma.
Source: Arthroscopy, The Journal of Arthroscopic and Related Surgery, April 2016