Hip Arthroscopy Complications: More on the Portal Syndrome
Can hip arthroscopy complications involve a gaping hole? I blogged awhile back on what I call the hip arthroscopy “portal syndrome”. I have a collection of patients who have had one or more hip arthroscopies who have an obvious open portal on their MRIs. This is the place where the arthroscopy equipment goes that should quickly heal, but instead the area is a gaping tissue tunnel. They all have chronic pain in this general area and all found no relief with hip arthroscopy surgery that was performed to “fix” their hip impingements. Yesterday we were performing diagnostic blocks on one of those patients (the woman highlighted in the prior post) to see if her hip joint was the remaining source for her pain. I was very surprised to see just how big the unhealed hip arthroscopy portal was in this woman (image above). Note that the radiographic contrast in the black dashed circle shouldn’t be there. This means her joint now freely communicates with the surrounding muscles, something nature never designed. Is this the cause of her pain? I’m not sure as it could also be the joint itself or a nerve that was injured by the two hip arthroscopies on this hip. Either way, disrupting the joint capsule in this way can’t be good. The upshot? If the first hip arthroscopy doesn’t succeed, don’t “double down” for a second!