Complications of Hip Endoscopy in the Treatment of Subgluteal Space Pathologies

Aguilera-Bohórquez, Bernardo; Pacheco, Julio; Castillo, Lizardo; Calvache, Daniela; Cantor, Érika

doi:10.1016/j.arthro.2021.02.016

Cited by 5 publications

(8 citation statements)

References 31 publications

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“…Lesser trochanter resection can also be successfully performed endoscopically, as previously described by several authors. [18][19][20][21][22] Several complications have been reported with the endoscopic approach, including temporary sciatic nerve injury, hematoma, permanent nerve injury of the posterior femoral cutaneous nerve, 23 and intra-abdominal fluid extravasation. 24 This method does incur a steeper learning curve as well as less direct visualization of the important surrounding neurovascular structures; consequently, entrapment of the sciatic nerve is the leading reported cause of revision surgery.…”

Section: Discussionmentioning

confidence: 99%

“…24 This method does incur a steeper learning curve as well as less direct visualization of the important surrounding neurovascular structures; consequently, entrapment of the sciatic nerve is the leading reported cause of revision surgery. 23 Complications from an endoscopic approach can be severe, and an open approach may reduce the risk of several of these complications.…”

Section: Discussionmentioning

confidence: 99%

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Open Ischiofemoral Impingement Decompression

Gabrielli

Tisherman²,

Curley³

et al. 2022

Arthroscopy Techniques

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Open Ischiofemoral Impingement Decompression

Gabrielli

Tisherman²,

Curley³

et al. 2022

Arthroscopy Techniques

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“…Deep gluteal syndrome (DGS) is broadly defined as compression or entrapment of the sciatic nerve as it courses under the gluteus maximus within the deep gluteal space. 1,[4][5][6] There are several possible sources of compression, the most common being fibrous bands of scar tissue around the sciatic nerve.…”

Section: Video Transcriptmentioning

confidence: 99%

Endoscopic Sciatic Neurolysis for Deep Gluteal Space Syndrome

Trasolini

Rice

Paul

et al. 2022

Video Journal of Sports Medicine

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Background: Deep gluteal syndrome (DGS) encompasses a spectrum of pathologies causing symptomatic sciatic nerve compression deep to the gluteus maximus muscle. Endoscopic sciatic neurolysis is an option for management of DGS when conservative treatment fails. Indications: Endoscopic sciatic neurolysis is indicated for retro-trochanteric pain, sciatica-like burning in the posterior thigh, and sitting discomfort that is reproducible on physical examination after failing conservative management. Technical Description: The technique presented here introduces a standard endoscopic sciatic neurolysis technique with an accessory posterolateral portal placed distally and in line with the sciatic nerve. Use of a switching stick through an accessory distal posterolateral portal can allow for in-line protection and retraction of the sciatic nerve while it is carefully released from compressive fibrous bands using an arthroscopic shaver. It is important that the accessory portal be placed under direct visualization with caution not to injure the sciatic nerve. An arthroscopic radiofrequency device can be used for hemostasis and further release of fibrous bands. At the end of the procedure, the sciatic nerve should be visualized fully released and freely mobile from the piriformis muscle to the level of the lesser trochanter. Results: In properly selected patients, the procedure is very successful. In a series of 35 cases, the procedure reduced sitting pain (present in 97% of patients preoperative, 17% of patients postoperative), reduced narcotic use, improved visual analog scale (VAS) pain scores, and improved modified Harris hip scores without major complications. Discussion: Although rare following hip arthroscopy, postoperative scarring and fibrous bands are a common cause of DGS which can be effectively treated by endoscopic sciatic nerve decompression. Results of endoscopic sciatic neurolysis have thus far been encouraging with improvements in patient reported outcome scores and high rates of satisfaction. However, complications do occur and can result in neurologic deficits. Nevertheless, with careful patient selection and meticulous sciatic nerve dissection, endoscopic sciatic neurolysis for DGS is a safe and effective technique for decompression of fibrous bands and adhesions that can lead to sciatic neuralgia.

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“… ‡ References 1, 2, 3, 4, 5, 6, 7, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 21, 22, 23, 24, 25, 27, 28, 29, 31, 32, 33, 35, 36, 37, 38, 39, 40, 42, 43, 44, 45, 46, 47, 48, 49. …”

mentioning

confidence: 99%

“… ‖ References 1, 2, 3, 7, 9, 11, 15, 17, 18, 19, 21, 23, 25, 28, 29, 31, 33, 35, 36, 37, 38, 39, 40, 42, 43, 46, 47, 48. …”

mentioning

confidence: 99%

Systematic Review of Complications Associated With Proximal Hamstring Tendon Repair

Lawson,

Abraham,

Imbergamo

et al. 2023

Orthopaedic Journal of Sports Medicine

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Background: Although several complications of proximal hamstring tendon ruptures have been reported in the literature, few studies have comprehensively analyzed the complication profile of proximal hamstring tendon repair. Purpose: To identify the overall rate of complications following proximal hamstring tendon repair and to differentiate these complications into categories. Study Design: Systematic review; Level of evidence, 4. Methods: Included in this review were studies that examined surgical repair of proximal hamstring tendon ruptures; all studies were in English and had an evidence level of 4 or higher. No restrictions were made regarding publication date or methodological quality. Data regarding complications were extracted to calculate the overall complication rate as well as the rate of major and minor complications. A quantitative data synthesis was conducted using the chi-square test to compare the proportion of patients who experienced complications with the endoscopic versus open approach. Results: A total of 43 articles including 2833 proximal hamstring tendon repairs were identified. The overall postoperative complication rate was 15.3% (n = 433). The rate of major complications was 4.6%, including a 1.7% rate of sciatic nerve injury, 0.8% rate of venous thromboembolism, 0.8% reoperation rate, 0.8% rerupture rate, and 0.4% rate of deep infection. Minor complications included a 2.4% rate of posterior femoral cutaneous nerve injury, 2.3% rate of persistent hamstring myopathy, 2.2% rate of persistent sitting pain, 1.8% rate of peri-incisional numbness, 1.1% rate of superficial infection, and 0.8% rate of hematoma/seroma. Conclusion: Proximal hamstring tendon repair is associated with an overall complication rate of 15.3%, including a 4.6% rate of major complications.

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Complications of Hip Endoscopy in the Treatment of Subgluteal Space Pathologies

Cited by 5 publications

References 31 publications

Open Ischiofemoral Impingement Decompression

Open Ischiofemoral Impingement Decompression

Endoscopic Sciatic Neurolysis for Deep Gluteal Space Syndrome

Systematic Review of Complications Associated With Proximal Hamstring Tendon Repair

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