Abstract
Introduction: Intra-articular lidocaine injections have been used to confirm the hip pathology and may predict the efficacy of arthroscopic surgery. We have routinely performed the injections as a surgical indicator. The aim of this study was to assess the duration and effectiveness of these diagnostic intra-articular lidocaine injections on groin pain in patients with labral tears involving early osteoarthritis. Methods: A total of 113 patients were included in this study. All patients received one injection of 10 ml of 1% lidocaine into the hip joint under fluoroscopy. The duration and effectiveness of the injection were assessed 2 weeks after the injection and at a minimum of 1 year of follow-up. The effect of the injection was graded as 0: unchanged or worse; 1: an effect only on the day of injection; 2: the effect lasted a few days; 3: the effect lasted about a week; and 4: symptom remission. In addition, we recorded whether hip arthroscopic surgery was eventually performed. Results: The effect was rated as 0 in 19 patients (16.8%), as 1 in 30 patients (26.5%), as 2 in 38 patients (33.6%), as 3 in 13 patients (11.5%), and as 4 in 13 patients (11.5%). Seventy-two patients (63.7%) underwent hip arthroscopic surgery. No relationship with patients’ characteristics was found. Conclusion: In total, 83% of patients experienced some effect of the lidocaine injection. Furthermore, 11.5% of patients experienced complete remission of their symptoms.
Highlights
In recent years, hip arthroscopy has become a common surgical procedure in both the diagnosis and treatment of painful hip disorders
We evaluated the records for the extent of OA using the Tönnis classification [9] and radiological findings related to femoroacetabular impingement (FAI)
Age was significantly higher in patients with OA grade 1 and 2 than in patients with OA grade 0 (56.6 ± 1 2.9 vs. 37.6 ± 14.6, P < 0.001), there were no significant differences in sex (P = 0.0589) and incidence of radiographical findings of FAI (P = 0.842), including each type of deformity
Summary
Hip arthroscopy has become a common surgical procedure in both the diagnosis and treatment of painful hip disorders. Arthroscopic hip treatments typically result in good clinical outcomes, with low rates of complications and relatively rapid rehabilitation [1, 2]. Pain around the hip joint may originate from different locations, including extra-articular origins and the lumbar spine [3,4,5]. Arthroscopic treatments should be targeted at patients with pain of an intra-articular source. Intra-articular lidocaine injections might be useful as a method to confirm the hip pathology and predict the efficacy of hip arthroscopic surgery. Consistent with this, several reports have described the usefulness of preoperative diagnostic intra-articular injections [6,7,8]
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