Pudendal nerve neuralgia after hip arthroscopy: Retrospective study and literature review
Régis Pailhé,Philippe Chiron,Nicolas Reina,Etienne Cavaignac,V. Lafontan,Jean-Michel Laffosse +5 more
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TLDR
The present study found 2% incidence of pudendal neuralgia, with no risk factors emerging from analysis, among 150 patients undergoing hip arthroscopy between 2000 and 2010.Abstract:
Summary Introduction Pudendal nerve neurapraxia is a classic complication after traction on the fracture table. Diagnosis, however, is difficult and often overlooked, especially after arthroscopy in traction on fracture table; incidence is therefore not known exactly. Hypothesis The study hypothesis was that incidence of pudendal nerve neuropathy exceeds 1% after hip arthroscopy. Materials and methods Results for 150 patients (79 female, 71 male) undergoing hip arthroscopy between 2000 and 2010 were analyzed retrospectively. The principal assessment criterion was onset of pudendal neuralgia. Secondary criteria were risk factors (history, surgery time, type of anesthesia), associated complications, onset to diagnosis interval and pattern of evolution. Results At a mean 93 months’ follow-up, there were 3 cases (2 women, 1 man) (2%) of pure sensory pudendal neuralgia; 2 concerned labral lesion resection and 1 osteochondromatosis. Surgery time ranged from 60 to 120 min, under general anesthesia with curarization. Time to diagnosis was 3 weeks. No complementary examinations were performed. Spontaneous resolution occurred at 3 weeks to 6 months. No significant risk factors emerged. Conclusion The present study found 2% incidence of pudendal neuralgia, with no risk factors emerging from analysis. Prevention involves limiting traction force and duration by using a large pelvic support (diameter > 8–10 cm). Patient information and postoperative screening should be systematic. Level of evidence Level IV. Retrospective study.read more
Citations
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Journal ArticleDOI
Hip arthroscopic capsulotomy techniques and capsular management strategies: a systematic review.
Seper Ekhtiari,Darren de Sa,Chloe E. Haldane,Nicole Simunovic,Christopher M. Larson,Marc R. Safran,Olufemi R. Ayeni +6 more
TL;DR: Overall, post-operative instability is rare and there is no consistent trend for capsular management strategy, while capsular closure/plication may be suitable for specific populations (i.e., dysplasia or laxity), evidence-based indications for Capsular repair remain unclear.
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Hip Distraction Without a Perineal Post: A Prospective Study of 1000 Hip Arthroscopy Cases.
TL;DR: The use of the Trendelenburg position and a specially designed distraction setup during hip arthroscopy allows for safe hip distraction without a perineal post, thereby eliminating groin-related soft tissue and nerve complications.
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Pudendal nerve injury is a relatively common but transient complication of hip arthroscopy.
Anthony Habib,Chloe E. Haldane,Seper Ekhtiari,Darren de Sa,Nicole Simunovic,Etienne L. Belzile,Olufemi R. Ayeni +6 more
TL;DR: Pudendal nerve injury is not uncommon following hip arthroscopy, with a reported rate found in this review of 1.8%.
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Neurogenic Pelvic Pain
TL;DR: Treatment of pelvic neuralgia includes conservative measures such as pelvic physical therapy, lifestyle modification, and medications with escalation to more invasive and novel treatments such as nerve blocks, radiofrequency ablation, cryoablation, neuromodulation and neurectomy/neurolysis if conservative treatments are ineffective.
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CT-guided Perineural Injections for Chronic Pelvic Pain
TL;DR: The technique of perineural injection of major pelvic nerves, illustrates the different target sites with representative case examples, and discusses the pitfalls are outlined.
References
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Journal ArticleDOI
Diagnostic criteria for pudendal neuralgia by pudendal nerve entrapment (Nantes criteria).
Jean-Jacques Labat,Thibault Riant,Roger Robert,Gérard Amarenco,Jean-Pascal Lefaucheur,Jérome Rigaud +5 more
TL;DR: Criteria that can help to the diagnosis of pudendal neuralgia by pUDendal nerve entrapment syndrome are defined.
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Complications of hip arthroscopy
TL;DR: Most of the complications were transient neuropraxias and fluid extravasations resulting in no permanent damage and severe scuffing of two femoral heads was considered serious and permanent, resulting in a 0.5% rate in this series for significant complications.
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Hip arthroscopy by the lateral approach
TL;DR: In this article, the authors describe a new technique by which arthroscopy of the hip provides complete visualization of the joint space, and insert the arthroscope and operative instruments by a direct lateral approach over the greater trochanter with the patient in the lateral decubitus position.
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Intraoperative positioning nerve injuries
TL;DR: Intraoperative positioning nerve injuries are regrettable complications of surgery thought to arise from stretch and/or compression of vulnerable peripheral nerves and typically improve completely over time.