Pain management practice patterns after hip arthroscopy: an international survey

Author:

Garcia Flávio L123,Williams Brady T1,Maheshwer Bhargavi1,Bedi Asheesh4,Wong Ivan H5ORCID,Martin Hal D6,Nho Shane J1,Chahla Jorge1

Affiliation:

1. Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush Medical College of Rush University, Rush University Medical Center, 1611 W Harrison St, Chicago, IL, 60612, USA

2. Department of Orthopaedic Surgery, Instituto Brasil de Tecnologias da Saúde, Rio de Janeiro, RJ, Brazil, Rua Visconde de Pirajá, 407 Rio de Janeiro, RJ, 22410-003, Brazil

3. Department of Orthopaedics and Anesthesiology, Ribeirão Preto Medical School of the University of São Paulo, Ribeirão Preto, Avenida Bandeirantes, 3900 Ribeirão Preto, SP, 14049-900, Brazil

4. Department of Orthopaedic Surgery, University of Michigan, 1500 E Medical Center Drive Ann Arbor, MI, 48109, USA

5. Department of Surgery, Dalhousie University, Halifax, 6299 South St Halifax, NS, B3H 4R2, Nova Scotia, Canada

6. Hip Preservation, aylor University Medical Center, 411 N Washington Ave, Suite 7300 Dallas, TX, 75246, USA

Abstract

Abstract Several post-operative pain control methods have been described for hip arthroscopy including systemic medications, intra-articular or peri-portal injection of local anesthetics and peripheral nerve blocks. The diversity of modalities used may reflect a lack of consensus regarding an optimal approach. The purpose of this investigation was to conduct an international survey to assess pain management patterns after hip arthroscopy. It was hypothesized that a lack of agreement would be present in the majority of the surgeons’ responses. A 25-question multiple-choice survey was designed and distributed to members of multiple orthopedic professional organizations related to sports medicine and hip arthroscopy. Clinical agreement was defined as > 80% of respondents selecting a single answer choice, while general agreement was defined as >60% of a given answer choice. Two hundred and fifteen surgeons completed the survey. Clinical agreement was only evident in the use of oral non-steroidal anti-inflammatory drugs (NSAIDs) for pain management after hip arthroscopy. A significant number of respondents (15.8%) had to readmit a patient to the hospital for pain control in the first 30 days after hip arthroscopy in the past year. There is significant variability in pain management practice after hip arthroscopy. The use of oral NSAIDs in the post-operative period was the only practice that reached a clinical agreement. As the field of hip preservation surgery continues to evolve and expand rapidly, further research on pain management after hip arthroscopy is clearly needed to establish evidence-based guidelines and improve clinical practice.

Funder

American Orthopaedic Society for Sports Medicine

European Society of Sports Traumatology, Knee Surgery and Arthroscopy

International Society for Hip Arthroscopy (ISHA), Brazilian Hip Society

Latin American Society of Arthroscopy

Publisher

Oxford University Press (OUP)

Subject

General Earth and Planetary Sciences,General Environmental Science

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