Effect of Warmed Irrigation in Hip Arthroscopy Undergoing Hip Arthroscopy

Study Overview
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Brief Summary
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The purpose of this study is to determine if pre-warming of arthroscopic fluid reduces immediate post-surgical pain in hip arthroscopy patients. The investigators hypothesize there will be a significant decrease in the Visual Analog Score (VAS) measured 30 minutes post-operatively in the warmed fluid group compared to the control group. Secondary outcome measures to be collected will include VAS scores 60 minutes after surgery and on post-operative day (POD) one. Additionally, the investigators will collect post-operative temperature measured 30 and 60 minutes post-operatively as well as morphine equivalent dosing in PACU and at the two-week follow up visit.

Detailed Description
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In the last two decades, hip arthroscopy for the treatment of femoral acetabular impingement has increased rapidly. Currently, over 30k hip scopes are performed annually in the United States (incidence 1.06 per 10K). Due to anatomical differences, hip arthroscopy procedures have the potential for significant fluid extravasation when compared to knee arthroscopy. A 2011 study on hip arthroscopy showed on average 9.68 liters of fluid were used for a standard hip procedure; of that 1.13 liters absorbed into the surrounding soft tissues. A recent systematic review and meta-analysis showed warming of arthroscopic fluids significantly decreased the risk of hypothermia during hip arthroscopy. Additionally, active warming has been shown to decrease the rate of surgical site infection during numerous procedures. In total knee arthroplasty patients, a forced air warming gown significantly reduced narcotic pain consumption compared to standard care. However, the benefits of active warming for decreasing post-operative pain has not been studied in hip arthroscopy patients. Specifically, the investigators were interested in the roll the pre-warming arthroscopic fluid plays in post-operative pain after hip arthroscopy. The purpose of this study is to see if pre-warming of arthroscopic fluid reduces immediate post-surgical pain and narcotic consumption in hip arthroscopy patients.

Official Title
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Effect of Warmed Irrigation Fluid on Immediate Post-operative Pain Scores in Patients Undergoing Hip Arthroscopy

Conditions
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Femoro Acetabular Impingement, Pain, Postoperative

Intervention / Treatment
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* Procedure: Warmed Arthroscopic Fluids
* Procedure: Room Temperature Arthroscopic Fluids


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All patients aged 18-65 years with a confirmed diagnosis of Femoroacetabular impingement (FAI) Required hip arthroscopy will be considered for the study Pre-operative history and physical exam Magnetic resonance imaging (MRI) before being indicated for arthroscopic surgery Exclusion Criteria: Taking narcotic medications at baseline Have a history of complex regional pain syndrome, Have hip arthritis, Have undergone previous hip arthroscopic surgery, or Are deemed incapable by the Principal Investigator of completing the study.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Prospective Randomized Controlled Trial
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Warmed Arthroscopic Fluids<br>Arthroscopic Fluids will be warmed to 38 degrees Celsius during procedure with active warming device. Temperature will be measured in real time. | Procedure: Warmed Arthroscopic Fluids<br>* Warmed Arthroscopic Fluids<br>|
| Active Comparator: Room Temperature Arthroscopic Fluids<br>Arthroscopic fluids will be kept at room temperature and will not be warmed per current standard of care. Temperature will be measured in real time. | Procedure: Room Temperature Arthroscopic Fluids<br>* Room Temperature Arthroscopic Fluids<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in Visual Analog Score | A Visual Analog Score (VAS) will be measured pre-operatively, 30 and 60 minutes after patient arrival in the post-anesthesia care unit (PACU). Additionally, VAS will be collected in the clinic on post-operative day (POD) 1 and POD 14. The visual analog scale measures subject reported pain on a scale of 0-100 with a score of 0 indicating no pain and 100 indicating the worst pain possible. | Pre-operatively, 30 and 60 minutes after completion of surgery, Post Op Days 1 and 14. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in Temperature | Subject core temperature will be collected 30 and 60 minutes after arrival in PACU. The method for collection will be done via current standard of care. | 30-60 minutes after after completion of surgery | 
| Morphine Equivalent Dosage (MED) | Morphine equivalent dose (MED) will be calculated in PACU and at the subject's routine two-week post-operative appointment via medication reconciliation. | After completion of surgery and at the 2-week Post Operative Visit | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Hip Arthroscopy, Warmed Fluids