{
  "abstract": "Background:: Pudendal nerve palsy (PNP) is a poorly characterized and underreported postoperative complication of hip arthroscopy (HA) with a perineal post. PNP may result in external genital numbness and sexual dysfunction in both men and women.\n\nPurpose:: To describe the incidence, breadth, and duration of postoperative PNP symptoms and to evaluate the relationship between PNP and intraoperative limb traction.\n\nStudy Design:: Cohort study; Level of evidence, 3.\n\nMethods:: All patients underwent primary unilateral HA in a supine position with a perineal post. Patients with preexisting PNP symptoms, including sexual dysfunction, were excluded. Intraoperative traction duration and force were recorded using a sensor applied to the perineal post. A PNP screening questionnaire and validated sexual function questionnaires were administered confidentially at 2 weeks, 6 weeks, 3 months, 6 months, and 12 months postoperatively. Patient-reported hip outcomes (International Hip Outcome Tool–33 [iHOT-33]) were completed preoperatively and at 6 and 12 months.\n\nResults:: A total of 93 patients were included (mean age, 36.4 years [SD, 9.2 years]; 55% male). The mean traction duration was 80 minutes (SD, 19 minutes). In the acute postoperative period, 77 (83%) patients experienced symptoms consistent with PNP. The most common symptoms were perineal numbness (75%), paresthesia (26%), and pain (18%). Urogenital or sexual dysfunction occurred in 39%, including erectile dysfunction in 22% of men and reduced sexual lubrication in 19% of women. At 3 months postoperatively, 26% of patients continued to have PNP symptoms, with 14% persisting to at least 6 months; all symptoms resolved by 12 months. Patients with PNP had greater traction force (MD, 18.1 kg; 95% CI, 0.3 to 37.1 kg) and longer traction time (MD, 15.4 minutes; 95% CI, 5.5 to 25.3 minutes). Longer traction duration was associated with increased odds of PNP (OR per additional 10 minutes, 1.59; 95% CI, 1.12 to 2.37). Persistence of symptoms beyond 6 weeks was associated with lower iHOT-33 scores at 6 months (MD, −14.4; 95% CI, −24.2 to −4.5).\n\nConclusion:: PNP symptoms were common after HA performed with perineal post traction, but most resolved within 6 months and all by 1 year. Increased traction duration and perineal pressure were significant predictors of symptom development, and persistent dysfunction correlated with lower hip-specific outcome scores.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Surgery, Division of Orthopaedic Surgery, University of Toronto, Toronto, Ontario, Canada",
    "Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada",
    "University of Toronto Orthopaedic Sports Medicine, University of Toronto, Toronto, Ontario, Canada",
    "Division of Orthopaedic Surgery, Women’s College Hospital, Toronto, Ontario, Canada",
    "Faculty of Kinesiology, University of Toronto, Toronto, Ontario, Canada",
    "Department of Physiatry and Rehabilitation Medicine, University of Toronto, Toronto, Ontario, Canada"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Graeme Hoit",
      "orcid": "0000-0001-5114-6999"
    },
    {
      "affs": [
        0,
        2,
        3
      ],
      "name": "Tim Dwyer"
    },
    {
      "affs": [
        0,
        1,
        2,
        3
      ],
      "name": "Jaskarndip Chahal"
    },
    {
      "affs": [
        0,
        2,
        4
      ],
      "name": "Timothy A. Burkhart",
      "orcid": "0000-0001-6185-2395"
    },
    {
      "affs": [
        4
      ],
      "name": "Evan Curd"
    },
    {
      "affs": [
        0
      ],
      "name": "Shgufta Docter"
    },
    {
      "affs": [
        5
      ],
      "name": "Jordan Farag",
      "orcid": "0000-0002-9209-6577"
    },
    {
      "affs": [
        0,
        2,
        3
      ],
      "name": "John Theodoropoulos"
    },
    {
      "affs": [
        0,
        2,
        3
      ],
      "name": "Daniel B. Whelan"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2tjryepvvrcc0.bib",
  "cited_by": 0,
  "doi": "10.1177/03635465261485701",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13736663/",
  "id": "2tjryepvvrcc0",
  "issns": [
    "0363-5465",
    "1552-3365"
  ],
  "landing_url": "https://doi.org/10.1177/03635465261485701",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Articles"
    ],
    [
      "heading",
      "Hip and Thigh"
    ],
    [
      "openalex",
      "2746|Hip disorders and treatments"
    ]
  ],
  "openalex": "W4416207313",
  "pdf_url": null,
  "pmcid": "PMC13736663",
  "pmid": "42813241",
  "published": "2026-09-30",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/2tjryepvvrcc0.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T12:22:04Z",
      "native_id": "PMC13736663",
      "source": "pmc",
      "url": "https://doi.org/10.1177/03635465261485701"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Hip disorders and treatments",
      "subfield": "surgery"
    }
  ],
  "title": "The Incidence and Breadth of Postoperative Pudendal Nerve Palsy and Its Relationship to Table Traction During Hip Arthroscopy With a Perineal Post",
  "title_text": "The Incidence and Breadth of Postoperative Pudendal Nerve Palsy and Its Relationship to Table Traction During Hip Arthroscopy With a Perineal Post",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T12:22:04Z",
  "url": "https://research.draconitic.com/paper/2tjryepvvrcc0",
  "venue": "The American Journal of Sports Medicine",
  "versions": []
}