Background Hip arthroscopy for treatment of femoroacetabular impingement (FAI) has developed rapidly and has been shown to significantly decrease pain and improve hip function. However, the relationship between hip capsule characteristics and healing after arthroscopic surgery and changes in patient-reported outcomes scores (PROs) for postoperative pain, function, and symptoms is still uncertain. Methods We retrospectively evaluated consecutive patients who were diagnosed with FAI and underwent hip arthroscopy for treatment in our hospital between May 2018 and November 2020. All patients had preoperative MRI and postoperative MRI at least 6 months after arthroscopy. Hip capsular thickness was measured at the proximal, middle, and distal site of the capsule. PROs and PROs at final follow-up were obtained, including visual analog scale (VAS) for pain and modified Harris Hip Score (mHHS). Results A total of 194 patients were included in this study. The mean MRI follow-up time was 14.3 (range, 6–37) months, and the mean clinical follow-up time was 26.1 (range, 12–43) months. Postoperative capsular thickness or net change were not correlated with postoperative PROs and VAS (P > .05). Capsular defect was observed in 17 (8.8%) patients. Patients with capsular defect had a relatively higher BMI (P < .05). Patients with capsular defect had a significant lower mHHS and higher VAS compared with patients with continuous capsule (P < .05). Ninety-one percentage of patients with continuous capsule surpassed minimal clinically important difference (MCID) and 80.8% achieved PASS, but only 58.8% of patients with capsular defect surpassed MCID and 47.1% achieved patient acceptable symptom state (PASS). Conclusions Postoperative capsular thickness may not have influence on the clinical outcomes of hip arthroscopy for treatment of FAI. Some capsule of patients who underwent arthroscopic interportal capsulotomy and repair could not heal. Postoperative capsular continuity had a great impact on the clinical outcomes of hip arthroscopy for FAI. Patients with higher BMI may be more likely to have capsule failure to heal.
Background Different from arthroscopy in other joints, more perfusion is required for a better access to perform surgical procedures in hip arthroscopic operations. The significant fluid perfused may lead to complications of partial tissue injury and electrolyte imbalance. However, there were few studies on the change of serum electrolyte after hip arthroscopy and the influential factors were still unknown. Methods We evaluated consecutive patients who underwent hip arthroscopy in our hospital between October 2021 and February 2022. Age, sex, and BMI matched patients who underwent arthroscopic anterior cruciate ligament (ACL) reconstruction at the same time were also included as the control group. Preoperative and postoperative serum electrolyte of sodium (Na +), potassium (K +), chloride (Cl-), magnesium (Mg2 +), and carbon dioxide capacity (CO2CP) were analyzed. The correlations between influential factors like perfusion volume, operating time, BMI and hip circumference, and changes in serum electrolyte were also analyzed. Results A total of 79 patients were involved in this study, including 49 patients who underwent hip arthroscopy and 30 patients who underwent knee arthroscopy. For hip arthroscopy, decrease of potassium levels was observed in 40.8% of the patients, and postoperative hypokalemia was found in 10.2% patients. There were significant variations in postoperative sodium, magnesium, chloride and carbon dioxide capacity in hip arthroscopy (p < 0.05). No correlations were found between each of the electrolyte concentrations and influential factors like perfusion volume, operating time, BMI, sex and hip circumference. The significant variations were found in chloride and carbon dioxide capacity in knee arthroscopy (p < 0.05). Conclusions Hip arthroscopy would significantly influence postoperative serum electrolyte, and hypokalemia could be a postoperative complication. The correlation between serum electrolyte and fluid perfusion volume is remained to be investigated. We therefor advocate that performing a systematic care of preoperative and postoperative serum electrolyte analysis as perioperative management is necessary.
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