Comparison of Complications in X-Ray Versus Ultrasound-Guided Hip Arthroscopy

Purpose: To report the complication rates and frequency of iatrogenic injury to the cartilage and labrum when using an ultrasound-guided hip arthroscopic technique compared with the standard x-ray–guided technique. Methods: In this retrospective cohort study of prospectively collected data, intraoperative videos were evaluated for iatrogenic injury during portal establishment. Postoperative complications and revision procedures were monitored for 12 months. Results: The study included 460 patients, with 38% in the ultrasound cohort. Video review showed a 2% complication rate of femoral head scuffing and <2% labral injury in both techniques, with no significant difference between techniques in cartilage injury (P = .90) or labrum puncture (P = .41). Six patients underwent revision procedures, 2 in the x-ray group and 6 in the ultrasound group. One patient developed a deep infection postoperatively. There were no other major complications. Conclusion: Ultrasound-guided hip arthroscopy is a safe alternative to the standard x-ray–guided procedure in patients with a BMI less than 35. Level of Evidence: III, retrospective cohort