Hip & pelvis

The Korean Hip Society (대한고관절학회)
권호 표지

Early Experiences and Complications of Hip Arthroscopy

고관절 관절경의 초기 경험과 합병증

  • Kim, Ki-Choul (Department of Orthopaedic Surgery, Pohang St. Mary’s Hospital) ;
  • Lee, Kyung-Hag (Department of Orthopaedic Surgery, Seoul National University Bundang Hospital) ;
  • Ha, Yong-Chan (Department of Orthopaedic Surgery, College of Medicine, Chung-Ang University) ;
  • Hwang, Deuk-Soo (Department of Orthopaedic Surgery, College of Medicine, Chungnam National University) ;
  • Kim, Jung-Taek (Department of Orthopaedic Surgery, College of Medicine, Seoul National University) ;
  • Kim, Hee-Joong (Department of Orthopaedic Surgery, College of Medicine, Seoul National University) ;
  • Koo, Kyung-Hoi (Department of Orthopaedic Surgery, College of Medicine, Seoul National University)
  • 김기철 (포항 성모병원 정형외과) ;
  • 이경학 (분당 서울대학교병원 정형외과) ;
  • 하용찬 (중앙대학교 의과대학 정형외과학교실) ;
  • 황득수 (충남대학교 의과대학 정형외과학교실) ;
  • 김정택 (서울대학교 의과대학 정형외과학교실) ;
  • 김희중 (서울대학교 의과대학 정형외과학교실) ;
  • 구경회 (서울대학교 의과대학 정형외과학교실)
  • Published : 2009.12.31

⟨ Previous Next ⟩

Abstract

Purpose: To report our early experience of hip arthroscopy. Materials and Methods: Forty one patients (45 hips) who underwent hip arthroscopy from November 2007 to February 2009 were enrolled in the study. The population was divided into 3 groups in sequence. The operation time, fluoroscopic time, traction time, and complications were analyzed. Results: There was no significant difference in operation time and traction time between the three groups. The fluoroscopic time decreased from 41 minutes in group I to 11 minutes in group III (p<0.01). There were four cases of nerve palsy; 2 pudendal nerve palsy in group I, 1 pudendal nerve palsy in group II, and 1 peroneal nerve palsy in Group III. All cases recovered completely within few days after surgery. Iatrogenic labral injury occurred in 4, 3 and 0 hips in group I, II and III, respectively. Iatrogenic cartilage damage to the femoral head occurred in 2, 3 and 1 hip in group I, II and III, respectively, which did not affect the outcomes.

목적: 고관절 관절경의 초기 경험에 대하여 기술하고자 한다. 대상 및 방법: 2007년 11월에서 2009년 2월까지 고관절 관절경을 시행 받은 41명(45예)의 환자를 대상으로 연구하였다. 연구 집단을 3개의 군으로 나누었으며(1군: 증례 1~15, 2군: 증례 16~30, 3군: 증례 31~45) 수술 시간, 투시 검사 시간, 견인 시간, 합병증 유무 및 종류에 대하여 분석하였다. 결과: 3개의 군에서 수술 시간 및 견인 시간은 통계적으로 유의한 차이가 없었다. 투시 검사 시간은 1군에서 41분, 3군에서 11분으로 감소하였다(p<0.01). 신경 손상은 총 4예가 발생하였으며 회음 신경 마비는 1군에서 2예, 2군에서 1예 발생하였고 비골 신경 마비는 3군에서 1예 발생하였으며 모두 수일 이내에 완전 회복되었다. 의인성 관절순 손상은 1군에서 4예, 2군에서 3예가 발생하였으나 3군에서는 발생하지 않았다. 의인성 대퇴 골두 손상은 1군에서 2예, 2군에서 3예, 3군에서 1예 발생하였으나 모두 수술 결과에 영향은 없었다. 결론: 고관절 관절경을 숙달하는 학습 과정에서 투시 검사 시간의 감소가 가장 명확하게 나타났다. 사망이나 영구적인 신경 손상과 같은 심각한 합병증은 발생하지 않았다.

Keywords

References

  1. Bartlett CS, DiFelice GS, Buly RL, Quinn TJ, Green DS, Helfet DL. Cardiac arrest as a result of intraabdominal extravasation of fluid during arthroscopic removal of a loose body from the hip joint of a patient with an acetabular fracture. J Orthop Trauma, 12: 294-299, 1998. https://doi.org/10.1097/00005131-199805000-00014
  2. Brumback RJ, Ellison TS, Molligan H, Molligan DJ, Mahaffey S, Schmidhauser C. Pudendal nerve palsy complicating intramedullary nailing of the femur. J Bone Joint Surg, 74-A: 1450-1455, 1992
  3. Burman MS. Arthroscopy or the direct visualization of joints: an experimental cadaver study. 1931. Clin Orthop Relat Res, 390: 5-9, 2001. https://doi.org/10.1097/00003086-200109000-00003
  4. Byrd JW, Jones KS. Prospective analysis of hip arthroscopy with 2-year follow-up. Arthroscopy, 16: 578- 587, 2000. https://doi.org/10.1053/jars.2000.7683
  5. Byrd JW. Avoiding the labrum in hip arthroscopy. Arthroscopy, 16: 770-773, 2000. https://doi.org/10.1053/jars.2000.7686
  6. Byrd JW. Hip arthroscopy utilizing the supine position. Arthroscopy, 10: 275-280, 1994. https://doi.org/10.1016/S0749-8063(05)80111-2
  7. Clarke MT, Arora A, Villar RN. Hip arthroscopy: complications in 1054 cases. Clin Orthop Relat Res, 406: 84-88, 2003. https://doi.org/10.1097/00003086-200301000-00014
  8. DeAngelis NA, Busconi BD. Hip arthroscopy in the pediatric population. Clin Orthop Relat Res, 406: 60-63, 2003. https://doi.org/10.1097/00003086-200301000-00010
  9. Dienst M, Seil R, Kohn DM. Safe arthroscopic access to the central compartment of the hip. Arthroscopy, 21: 1510-1514, 2005. https://doi.org/10.1016/j.arthro.2005.09.014
  10. Dorfmann H, Boyer TH, Henry P, DeBie B. A simple approach to hip arthroscopy. Arthroscopy, 4: 141-142, 1988.
  11. Funke EL, Munzinger U. Complications in hip arthroscopy. Arthroscopy, 12: 156-159, 1996. https://doi.org/10.1016/S0749-8063(96)90004-3
  12. Glick JM, Sampson TG, Gordon RB, Behr JT, Schmidt E. Hip arthroscopy by the lateral approach. Arthroscopy, 3: 4-12, 1987. https://doi.org/10.1016/S0749-8063(87)80003-8
  13. Grantcharov TP, Bardram L, Funch-Jensen P, Rosenberg J. Learning curves and impact of previous operative experience on performance on a virtual reality simulator to test laparoscopic surgical skills. Am J Surg, 185: 146- 149, 2003. https://doi.org/10.1016/S0002-9610(02)01213-8
  14. Griffin DR, Villar RN. Complications of arthroscopy of the hip. J Bone Joint Surg, 81-B: 604-606, 1999.
  15. Gross R: Arthroscopy in hip disorders in children. Orthop Rev, 6: 43-49, 1977.
  16. Lo YP, Chan YS, Lien LC, Lee MS, Hsu KY, Shih CH. Complications of hip arthroscopy: analysis of seventy three cases. Chang Gung Med J, 29: 86, 2006.
  17. McCarthy JC, Lee JA. Hip arthroscopy: indications, outcomes, and complications. Instr Course Lect, 55: 301- 308, 2006.
  18. Philippon MJ, Stubbs AJ, Schenker ML, Maxwell RB, Ganz R, Leunig M. Arthroscopic management of femoroacetabular impingement: osteoplasty technique and literature review. Am J Sports Med, 35: 1571-1580, 2007. https://doi.org/10.1177/0363546507300258
  19. Sampson T. Complications of hip arthroscopy. Clin Sports Med, 20: 831-835, 2001. https://doi.org/10.1016/S0278-5919(05)70288-X
  20. Villar R. Arthroscopic debridement of the hip: a minimally invasive approach to osteoarthritis. J Bone Joint Surg, 73-B: 170-171, 1991.