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Published on: July 2, 2021
Hip arthroscopy failure rates: a healthcare database analysis in the United States
Akshar P Thakkar1,2,3,4, Michael D Scheidt5, Shaheen Jadidi6
1Hip & Knee Joint Preservation Center, Department of Orthopaedics, Northwestern Medicine, 27650 Ferry Road, Warrenville, IL 60555, United States.
Insights
Hip arthroscopy has rising complication rates. Patients with psychiatric comorbidities are 1.74 times more likely to need hip reoperation within one year following the initial procedure.
Area of Science:
- Orthopedic Surgery
- Health Services Research
Background:
- Hip arthroscopy is increasingly performed, but rates of complications and revision surgery are also rising.
- Understanding factors associated with hip arthroscopy failure is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate hip arthroscopy failure rates, defined as reoperation or total hip arthroplasty (THA).
- To identify patient-specific factors, including psychiatric comorbidities, SSRI use, smoking, and obesity, associated with hip arthroscopy failure.
Main Methods:
- A retrospective query of the PearlDiver database included 19,067 patients undergoing hip arthroscopy.
- Failure was defined as ipsilateral THA or reoperation. Statistical analysis used Student's t-test and odds ratios (P < 0.05).
Main Results:
- Within two years, the hip arthroscopy failure rate was 11.42% for reoperation and 7.16% for THA, totaling 18.58% revision surgery.
- Revision femoroplasty was the most common reoperation (72%).
- Patients with psychiatric comorbidities were 1.74 times more likely to require reoperation within one year.
Conclusions:
- Hip arthroscopy demonstrates significant failure rates within two years, necessitating revision surgery.
- Pre-existing psychiatric comorbidities are a significant risk factor for early hip reoperation after arthroscopy.
Abstract:
With hip arthroscopy cases, there has been a concomitant increase in complications and the need for revision surgery. This study aims to further contribute to the literature regarding hip arthroscopy failure rates and associated patient factors following an index hip arthroscopy procedure. The PearlDiver database was queried for patients who had undergone hip arthroscopy. International Classification of Diseases, 10th Revision, Clinical Modification codes were used to ensure that follow-up was performed on the ipsilateral limb. Hip arthroscopy failure was defined specifically as subsequent ipsilateral total hip arthroplasty (THA) and reoperation, which were examined in all patients that met inclusion criteria. Independent patient variables, including psychiatric comorbidities, preoperative SSRI use, smoking, and obesity, were examined to identify an association with failure rates. A Student t-test, with a significance set at P < 0.05, was used for statistical comparisons of postoperative outcomes. Odds ratios were used to calculate the probability of short-term hip reoperation in patients with the above independent variables. A total of 19 067 hip arthroscopy patients were included in this study. Within 2 years from the index hip arthroscopy, there was an 11.42% failure rate as defined by subsequent reoperation and 7.16% failure rate as defined by revision to THA, with a total revision surgery rate of 18.58%. The most common reoperation procedure was revision femoroplasty (72%). Patients with an active diagnosis of a psychiatric comorbidity in the year leading up to a hip arthroscopy procedure were 1.74 times more likely to require a hip reoperation within 1 year (95% CI, 1.55-1.95).
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