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Pudendal nerve injury is a relatively common but transient complication of hip arthroscopy

  • Hip
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Hip arthroscopy is emerging as the standard of care for conditions involving the hip, and has a unique set of complications. The purpose of this review was to identify (1) the crude rate of pudendal nerve injury following hip arthroscopy and (2) the specific factors leading to pudendal nerve injury.

Methods

MEDLINE, EMBASE, and PubMed were searched from database inception to October 2016. Patient demographics, indications, surgical technique, complication rates, treatment approaches, and rehabilitation strategies were extracted.

Results

Twenty-four studies (n = 3405) were included, with the majority (66%) of studies being level IV evidence. The mean age was 33.9 ± 9.7 years (range 12–78) and 48.2% were males. Average follow-up was 30.2 ± 19.1 months. 62 patients were reported to have sustained pudendal nerve injury (1.8%) post-operatively, and all resolved within 6 weeks to 3 months. Of the seven studies that reported using a perineal post, 20 patients were diagnosed with pudendal nerve injury (4.3%), in contrast to two studies (189 patients) reporting only 0.5% pudendal nerve injury without the use of perineal post. Two studies commented on time of traction during surgical intervention with mean times of 98 and 68 min with complication rates of 10% and 6.6%, respectively.

Conclusions

Pudendal nerve injury is not uncommon following hip arthroscopy, with a reported rate found in this review of 1.8%. Potential risk factors may include the use of a perineal post and long traction times. All reported cases resolved within 3 months. Patients should be informed of complications related to pudendal nerve injury, which include sexual and urinary dysfunction.

Level of evidence

Level IV, systematic review of level I–IV studies.

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Authors and Affiliations

  1. Division of Orthopaedic Surgery, Department of Surgery, McMaster University Medical Centre, 1200 Main St W, Room 4E15, Hamilton, ON, L8N 3Z5, Canada

    Anthony Habib, Darren de SA & Olufemi R. Ayeni

  2. Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada

    Chloe E. Haldane & Seper Ekhtiari

  3. Department of Clinical Epidemiology and Biostatistics, Centre for Evidence Based Orthopaedics, McMaster University, Hamilton, ON, Canada

    Nicole Simunovic

  4. Faculty of Medicine, Laval University, Quebec City, Canada

    Etienne L. Belzile

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  1. Anthony Habib
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  4. Darren de SA
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  6. Etienne L. Belzile
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Correspondence to Olufemi R. Ayeni.

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Conflict of interest

Etienne Belzile has received institutional research Grants from Stryker, Zimmer-Biomet, Depuy-Synthes, ITO ltd, and Medtronic, and research grants from the Canadian Institutes of Health Research. Etienne Belzile is also an educational consultant for Stryker and Pendopharm. Both Olufemi Ayeni and Etienne Belzile are educational consultants for Smith and Nephew.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Habib, A., Haldane, C.E., Ekhtiari, S. et al. Pudendal nerve injury is a relatively common but transient complication of hip arthroscopy. Knee Surg Sports Traumatol Arthrosc 26, 969–975 (2018). https://doi.org/10.1007/s00167-017-4783-4

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  • DOI: https://doi.org/10.1007/s00167-017-4783-4

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