Increased Length of Surgery Is Associated With Increased Fluid Pump Pressure During Hip Arthroscopy.

Abstract

Background: Elevated fluid pump pressures during hip arthroscopy have been associated with surgical complications including fluid extravasation, abdominal compartment syndrome, and higher use of pain medication.

Purpose: To demonstrate the safe use of low pump pressures and to identify factors associated with the need for increased fluid pump pressure during hip arthroscopy.

Study design: Case-control study; Level of evidence, 3.

Methods: A retrospective review was performed on all patients who underwent hip arthroscopy by a single surgeon between 2020 and 2021. Patients maintaining a pump pressure ≤20 mm Hg during surgery were assigned to group A, and patients who required a pump pressure >20 mm Hg at any point during surgery were assigned to group B. Univariate and multivariate analyses were performed to assess for relationships between elevated pump pressure (>20 mm Hg) during hip arthroscopy and the patient's age, sex, length of surgery, body mass index, Beighton hypermobility score, lateral center edge angle, alpha angle, Tegner activity score, femoral shaft torsion angle, highest systolic blood pressure during surgery, number of suture anchors, and the presence of medical comorbidities (ie, hypertension, clotting disorder, or diabetes mellitus).

Results: A total of 103 patients (112 hips) were included. Group A consisted of 77 hips (54 female, 23 male) with a mean age of 33.3 years. Group B consisted of 35 hips (19 female, 16 male) with a mean age of 33.6 years. Multivariate regression analysis revealed that mean length of surgery was associated with a need to increase pump pressure (P < .001). On average, for every 1-minute increase in surgery duration, the odds of needing an increase in pump pressure increased by 2.0%. In addition, highest systolic blood pressure during surgery and number of anchors were associated with an elevated pump pressure on univariate analysis (P = .026 and P < .001, respectively).

Conclusion: For a majority of patients who underwent hip arthroscopy, a pump pressure of 20 mm Hg resulted in adequate visualization for the duration of the case. Increased length of surgery was associated with an elevated pump pressure during hip arthroscopy.