The Perineal Post for Hip Arthroscopy Is Dead Or At Least It Should Be

Traditionally, distraction of the hip joint during hip arthroscopy has been achieved with the use of a perineal post which acts as a counterforce. However, our knowledge of the potential complications related to the use of a perineal post continues to grow. While pudendal neurapraxia is the most common of these potential complications, the perineal post may also cause skin tears of the perineum, erectile dysfunction and, in rare cases, permanent pudendal nerve injury. In response, several techniques for performing postless hip arthroscopy have been developed in recent years. While some of these techniques are commercially available and some are  do-it-yourself , preliminary evidence has shown minimal risk of groin-related complications with these postless techniques. In addition to reducing complication rates, our research demonstrated significantly better patient-reported outcomes with postless compared to post-assisted hip arthroscopy at a minimum 1-year follow-up.