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Perineal Pressure During Hip Arthroscopy Is Reduced by Use of Trendelenburg: A Prospective Study With Randomized Order of Positioning

Authors

Lall AC, Saadat AA, Battaglia MR, Maldonado DR, Perets I, Domb BG
DOI: 10.1097/CORR.0000000000000804

Background

During hip arthroscopy, the use of traction can improve visualization but also lead to complications like nerve injuries and soft-tissue damage. This study investigates whether Trendelenburg positioning (head down) can reduce the pressure on the perineum during surgery.

Methods

A study was conducted on 50 patients undergoing hip arthroscopy. Pressure against the perineum was measured at various angles (0°, 5°, 10°, and 15°) of Trendelenburg positioning.

Key Findings

Trendelenburg positioning at 10° and 15° significantly reduced perineal pressure by 28% and 46%, respectively, compared to the neutral position (0°).

Conclusions

Using Trendelenburg positioning in hip arthroscopy reduces pressure on the perineum, which may help decrease complications such as nerve injuries and soft-tissue damage.

What Does This Mean for Patients

If you're undergoing hip arthroscopy, your surgeon may use Trendelenburg positioning to reduce perineal pressure and improve safety during the procedure.