Effect of Postless Hip Arthroscopy on Functional Outcomes, Perineal Complications, and Lumbosacral Complications.

Background: Postless traction has been developed to avoid perineal post-related complications in hip arthroscopy. While it is reported to reduce groin-related issues, its effect on overall nerve injury rates, as well as potential new complications such as lumbosacral discomfort, remains unclear. Hypothesis: Postless traction may be linked to improved clinical outcomes but may carry an increased risk of lumbosacral discomfort. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who underwent postless hip arthroscopy were compared with matched patients who underwent conventional post-assisted traction. Patient-reported outcomes, including the Hip Outcome Score-Activities of Daily Living and Sports subscales (HOS-ADL and HOS-SS), the International Hip Outcome Tool-12 (iHOT-12), and the modified Harris Hip Score (mHHS), were collected via follow-up over a mean period of 476 days, ranging from 404 to 560 days. Complications including sensory deficits, perineal injury, and lumbosacral discomfort were also assessed. Results: A total of 32 patients who underwent postless hip arthroscopy were compared with 64 patients in the control group undergoing post-assisted traction. There was no significant difference in the overall rate of sensory nerve injury between the 2 groups (31.3% vs 32.8%; Conclusion: Postless hip arthroscopy is associated with superior patient-reported functional outcomes. However, it shows no reduction in the overall rate of sensory nerve injury and is linked to a significantly higher risk of postoperative lumbosacral discomfort.