Complications in Arthroscopic Hip Surgery

Complications in Arthroscopic Hip Surgery

Arthroscopic hip surgery is a minimally invasive method widely used in the treatment of hip joint disorders. However, various complications can occur with this intervention as well. This article details common complications, risk factors, and prevention methods in arthroscopic hip surgery.

Arthroscopic hip surgery is an increasingly preferred minimally invasive method for treating pathologies of the hip joint such as femoroacetabular impingement (FAI), labral tears, and gluteus medius tears. Performed through small external incisions into the hip joint, this procedure offers advantages over open surgery in terms of recovery time and complication risk. However, no surgical intervention is free of complications, and arthroscopic hip surgery also carries various risks.

Complication risks in arthroscopic hip surgery depend on many factors, including the patient’s preoperative general health, the surgeon’s experience, the equipment used, the surgical technique, and the scope of the intervention. In terms of complication types, infection, nerve injuries, bleeding, joint stiffness, and thromboembolic events are among the most common issues. These complications are evaluated in detail below.

Surgical site infections are rare in arthroscopic hip surgery but can lead to serious consequences. Ensuring sterile conditions, minimizing operative time, and using appropriate prophylactic antibiotics are the main measures that reduce infection risk. With early diagnosis and proper treatment, infection can be brought under control.

Nerve injuries may affect structures such as the lateral femoral cutaneous nerve, femoral nerve, sciatic nerve, and pudendal nerve. Damage to these nerves during arthroscopic procedures may lead to temporary or permanent sensory loss, pain, and motor dysfunction. The risk of nerve injury can be reduced through careful portal placement and thorough knowledge of anatomical structures. Keeping the hip in extreme flexion or extension for prolonged periods may cause nerve stretch and increase the risk of neuropathy.

Bleeding is rarely severe but remains important due to the proximity of major vessels in the hip region. Careful intraoperative dissection and meticulous hemostasis are crucial to reduce bleeding complications. In cases requiring more invasive measures, embolization or open surgery may be necessary.

Joint stiffness (arthrofibrosis) presents with limitation of hip range of motion. It may increase especially in patients who undergo prolonged immobilization or receive inadequate postoperative rehabilitation. Early initiation of active and passive range‑of‑motion exercises can help prevent this complication.

Thromboembolic complications pose a potentially serious threat after hip surgery. The risks of deep vein thrombosis (DVT) and pulmonary embolism increase with the patient’s overall condition, prolonged operative time, and delayed mobilization. Prophylactic anticoagulant use, early mobilization, and appropriate compression methods reduce this risk.

Other complications include intra‑articular loose bodies, cartilage injury, capsular insufficiency, and recurrent tears. Particularly in patients undergoing labral repair or reconstruction, careful surgical technique and close postoperative follow‑up are required.

Minimizing complications in arthroscopic hip surgery relies heavily on surgeon experience and proper patient selection. Careful preoperative patient assessment, management of comorbid systemic diseases, and meticulous surgical planning significantly reduce complication rates. During the operation, mastery of anatomical structures and attention to soft‑tissue preservation are essential.

In the subsequent period, an effective rehabilitation program, early mobilization, and prompt recognition and management of complication signs increase treatment success. A multidisciplinary approach should be adopted to restore the hip joint to a functional and pain‑free state.

When performed with appropriate indications and technique, arthroscopic hip surgery can keep surgical risks to a minimum. However, awareness of potential complications and timely diagnosis and intervention are critical for patient safety.