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Hip arthroscopy is one of the fastest growing procedures amongst orthopedic sports medicine surgeons. The procedure has recently entered its 4th decade of being performed and over this time many evolutions have occurred to the procedure to allow for improved efficiency and outcomes. In spite of these rapid evolving improvements, the risk of complication and untoward outcomes still exist due to the complexity of the procedure and the delicate anatomy of the surgical region. Perineal and sciatic nerve injuries related to the use of a perineal post for joint distraction are among the most devastating complications associated with hip arthroscopy. In order to combat these risks, a growing movement toward post-less arthroscopy has occurred. This technique allows for joint distraction without the need for a rigid post within the perineal region, thus decreasing the potential for nerve related complication. This manuscript aims to explore the arm of joint distraction in hip arthroscopy and examine the staying power of post-less hip arthroscopy.
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2. Shukla S, Pettit M, Kumar KHS, Khanduja V. History of hip arthroscopy. Journal of Arthroscopic Surgery and Sports Medicine. 2020;1(73):73-80.
3. Meek WM, Abraham PF, Kucharik MP, Martin SD. Limitations of Postless Hip Arthroscopy for a Patient with Coxa Profunda: A Case Report. JBJS Case Connect. 2021;11(1). doi:10.2106/JBJS.CC.20.00347
4. Sing DC, Feeley BT, Tay B, Vail TP, Zhang AL. Age-Related Trends in Hip Arthroscopy: A Large Cross-Sectional Analysis. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2015;31(12):2307-2313.e2. doi:10.1016/j.arthro.2015.06.008
5. Glick JM, Sampson TG, Gordon RB, Behr JT, Schmidt E. Hip arthroscopy by the lateral approach. Arthroscopy. 1987;3(1):4-12.
6. Byrd JWT, Thomas Byrd JW. Hip arthroscopy utilizing the supine position. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 1994;10(3):275-280. doi:10.1016/s0749-8063(05)80111-2
7. Domb B, Hanypsiak B, Botser I. Labral penetration rate in a consecutive series of 300 hip arthroscopies. Am J Sports Med. 2012;40(4):864-869.
8. Telleria JJM, Safran MR, Harris AHS, Gardi JN, Glick JM. Risk of sciatic nerve traction injury during hip arthroscopy—is it the amount or duration? An intraoperative nerve monitoring study. J Bone Joint Surg Am. 2012;94(22):2025-2032.
9. Mei-Dan O, Kraeutler MJ, Garabekyan T, Goodrich JA, Young DA. Hip Distraction Without a Perineal Post: A Prospective Study of 1000 Hip Arthroscopy Cases. Am J Sports Med. 2018;46(3):632-641.
10. Gedouin JE, May O, Bonin N, et al. Assessment of arthroscopic management of femoroacetabular impingement. A prospective multicenter study. Orthop Traumatol Surg Res. 2010;96(8 Suppl):S59-S67.
11. Kocher MS, Kim YJ, Millis MB, et al. Hip Arthroscopy in Children and Adolescents. Journal of Pediatric Orthopaedics. 2005;25(5):680-686. doi:10.1097/01.bpo.0000161836.59194.90
12. Nwachukwu BU, McFeely ED, Nasreddine AY, Krcik JA, Frank J, Kocher MS. Complications of Hip Arthroscopy in Children and Adolescents. Journal of Pediatric Orthopaedics. 2011;31(3):227-231. doi:10.1097/bpo.0b013e31820cadc5
13. Park MS, Yoon SJ, Kim YJ, Chung WC. Hip Arthroscopy for Femoroacetabular Impingement: The Changing Nature and Severity of Associated Complications Over Time. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2014;30(8):957-963. doi:10.1016/j.arthro.2014.03.017
14. Gupta A, Redmond JM, Hammarstedt JE, Schwindel L, Domb BG. Safety measures in hip arthroscopy and their efficacy in minimizing complications: a systematic review of the evidence. Arthroscopy. 2014;30(10):1342-1348.
15. Flecher X, Dumas J, Argenson JN. Is a hip distractor useful in the arthroscopic treatment of femoroacetabular impingement? Orthop Traumatol Surg Res. 2011;97(4):381-388.
16. Merrell G, Medvecky M, Daigneault J, Jokl P. Hip arthroscopy without a perineal post: a safer technique for hip distraction. Arthroscopy. 2007;23(1):107.e1-e3.
17. Mei-Dan O, McConkey MO, Young DA. Hip arthroscopy distraction without the use of a perineal post: prospective study. Orthopedics. 2013;36(1):e1-e5.
18. Suarez-Ahedo C, Olivos-Meza A, Lodhia P. Postless Hip Arthroscopy Using Standard Maquet Fracture Table With a Pink Hip Kit Positioning Device. Techniques in Orthopaedics. 2021;36(4):441.
19. Kollmorgen RC, Ellis T, Lewis BD, Harris JD. Achieving Post-Free Distraction in Hip Arthroscopy With a Pink Pad Patient Positioning Device Using Standard Hip Distraction Tables. Arthrosc Tech. 2019;8(4):e363-e368.
20. Perry AK, Gursoy S, Singh H, Vadhera AS, Mehta N, Chahla J. The Pink Pad: A Method of Post-Free Distraction During Hip Arthroscopy. Arthrosc Tech. 2021;10(8):e1897-e1902.
21. Welton KL, Garabekyan T, Kraeutler MJ, et al. Effects of Hip Arthroscopy Without a Perineal Post on Venous Blood Flow, Muscle Damage, Peripheral Nerve Conduction, and Perineal Injury: A Prospective Study. Am J Sports Med. 2019;47(8):1931-1938.
22. Schaver AL, Mattingly N, Glass NA, Willey MC, Westermann RW. Hip Arthroscopy With and Without A Perineal Post: A Comparison of Early Postoperative Pain. Arthroscopy. 2021;37(9):2840-2845.
23. Jimenez ML, Haneda M, Pascual-Garrido C. The Hip Arthroscopy Post-less Procedure Impingement (HAPPI) Technique: Achieving Distraction With Standard Hip Tables at Zero Additional Cost. Arthrosc Tech. 2020;9(11):e1697-e1701.