What Is Postless Hip Arthroscopy?
Hip arthroscopy is a minimally invasive surgery used to treat conditions such as femoroacetabular impingement (FAI), labral tears, and cartilage damage. Traditionally, the procedure requires traction to gently pull the hip joint apart, which has been achieved using a padded post placed between the patient’s legs.
Postless hip arthroscopy is a newer technique that eliminates the need for this perineal post. Instead, it uses alternative positioning methods to create traction, reducing the risk of complications associated with the post.
Why Move Away from the Perineal Post?
In traditional hip arthroscopy, the post helps apply traction but can place pressure on sensitive areas. This sometimes leads to complications such as:
- Numbness in the thigh or groin
- Pudendal nerve injury
- Perineal pain or bruising
Although often temporary, these complications can delay recovery. Postless techniques were developed to avoid these risks.
How Does Postless Hip Arthroscopy Work?
Instead of using a post, surgeons employ different positioning methods to achieve traction:
- Trendelenburg positioning: The surgical table is tilted, and the patient’s body weight provides counter-traction.
- Specialised traction tables or pads: Devices distribute force across the body rather than concentrating it in one area.
This allows surgeons to access the hip joint without putting pressure on the perineum.
Benefits of Postless Hip Arthroscopy
1. Reduced Risk of Nerve Injury
By removing the post, there is less chance of pudendal nerve compression and resulting numbness or tingling.
2. Less Perineal Pain
Patients often report greater comfort during recovery compared to traditional methods.
3. Safe and Effective Joint Access
Surgeons can still achieve excellent visibility and access to the hip joint.
4. Better Patient Satisfaction
Improved safety and comfort contribute to higher overall satisfaction after surgery.
Who Is a Candidate for Postless Hip Arthroscopy?
Most patients who are eligible for standard hip arthroscopy can undergo the postless version. It is particularly beneficial for:
- Athletes and active patients wanting faster, more comfortable recovery
- Patients concerned about nerve-related side effects
- Cases requiring longer traction times
Recovery After Postless Hip Arthroscopy
Recovery is similar to traditional hip arthroscopy and typically includes:
- Crutches for the first 1–2 weeks
- Structured physiotherapy to restore mobility and strength
- Gradual return to sports or high-impact activities within 3–6 months
The difference lies in potentially fewer traction-related complications, which may allow smoother early recovery.
Conclusion
Postless hip arthroscopy is a modern advancement in hip surgery that eliminates the need for a perineal post. By reducing the risk of nerve injury and perineal pain, it offers patients a safer and more comfortable alternative while maintaining excellent surgical outcomes.
If you are considering hip arthroscopy, ask your surgeon whether the postless technique is available and suitable for your case.