Preoperative Colonoscopy Is a Risk Factor for Reoperation Following Primary Total Hip Arthroplasty: A...

Area of Science:

• Orthopedic Surgery
• Gastroenterology
• Health Services Research

Background:

• Limited research exists on the reoperation risk following total hip arthroplasty (THA) in patients who have undergone preoperative colonoscopy.
• Both THA and colonoscopy are common procedures for similar patient demographics, highlighting a gap in understanding their combined impact.

Purpose of the Study:

• To investigate the association between preoperative colonoscopy and the risk of reoperation after primary THA.
• To determine if the timing of colonoscopy relative to THA influences reoperation rates.

Main Methods:

• A retrospective cohort study using administrative data from Ontario, Canada (2003-2020).
• Identified patients undergoing primary THA for osteoarthritis and matched those with preoperative colonoscopy (≤1 year prior) to controls (1:10 ratio) using propensity score matching.
• Analyzed reoperation rates within five years post-THA using Cox Proportional Hazards models.

Main Results:

• 1,515 patients with preoperative colonoscopy were matched to 15,150 controls.
• The reoperation rate within five years was 4.0% in the colonoscopy group versus 2.8% in the control group.
• Preoperative colonoscopy within 12 months was associated with a 1.39-fold increased risk of reoperation, with the risk rising to 1.91-fold if performed within 83 days of THA.

Conclusions:

• Diagnostic colonoscopy up to 12 months before THA may increase the risk of postoperative reoperation.
• A temporal relationship exists, with higher reoperation risk observed when colonoscopy is performed closer to the THA date.