EP1.1 Complications of hip arthroscopy due to misplacement of anchors in labral repairs: Report of 3 cases

Hip arthroscopy (HA) is a minimally invasive surgical technique for treating labral and cartilage injuries in patients with femoroacetabular impingement. Its indication has exponentially increased in recent years. Complications reported are rare, ranging from 1.4%-8% of cases.

Three patients underwent surgical treatment within the last year who consulted for progressive pain after hip arthroscopy with fixation of the acetabular labrum are presented. In all cases an intra-articular anchor (IAA) with secondary chondral lesions was confirmed as the cause of the pain.

A 20-year-old female patient underwent HA five years ago with repair of the acetabular labrum. She experiences progressive coxalgia. X-rays show narrowing of the joint space. MRI reveals synovitis, bone edema of the femoral head, and chondral lesions in the acetabulum and femoral head. Total hip arthroplasty (THA) is performed, revealing an anchor in the joint space as the cause of advanced chondral damage.

A 32-year-old female patient underwent HA with repair of the acetabular labrum one year ago. She experiences progressive pain early in the postoperative period. MRI indicates signs of osteochondral lesion in the femoral head. Revision arthroscopy reveals an IAA in the acetabulum with focal cartilage damage in the femoral head. During revision arthroscopy, the anchor is removed, acetabular and femoral chondroplasty is performed, and new labrum sutures are placed, resulting in a very satisfactory outcome.

A 56-year-old male patient underwent hip arthroscopy eight months ago and experiences progressive pain post-arthroscopy. Current X-rays show narrowing and collapse of the joint space, while MRI displays extensive cartilage damage. Treatment with THA is performed, confirming an IAA in the acetabular zone as the cause of the articular cartilage damage.

Cartilage lesions due to an intra-articular anchor are sparsely reported in the literature. In the case of an initial injury, revision arthroscopy with anchor removal and chondroplasty is indicated. In cases of advanced damage, hip arthroplasty was performed in two cases. This severe complication associated with the surgical technique reinforces the need for adequate learning in its surgical technique, strengthening educational activities with the aim of performing this surgery effectively and safely.