Malviya Ajay, Raza Ali, Jameson Simon, James Philip, Reed Mike R, Partington Paul F
Department of Orthopaedics, Northumbria Healthcare NHS Foundation Trust, Ashington, England.
Department of Orthopaedics, Northumbria Healthcare NHS Foundation Trust, Ashington, England.
Arthroscopy. 2015 May;31(5):836-42. doi: 10.1016/j.arthro.2014.12.013. Epub 2015 Feb 7.
Our study aimed to identify the complications of hip arthroscopies with particular emphasis on the 30-day readmission rate; 90-day deep vein thrombosis (DVT) and pulmonary embolism (PE) rate and mortality rate; revision hip arthroscopy rate; and in particular, survivorship with conversion to total hip replacement (THR) as the endpoint.
The records of patients undergoing hip arthroscopy were extracted from the administrative hospital admissions database covering all admissions to the National Health Service hospitals in England using ICD-10 (International Statistical Classification of Diseases and Related Health Problems, 10th Revision) and OPCS-4 (Office of Population Censuses and Surveys Classification of Surgical Operations and Procedures, fourth revision) codes.
A total of 6,395 hip arthroscopies were included in the study period. The 30-day readmission rate was 0.5%; both the 90-day DVT rate and PE rate were 0.08%; and the 90-day mortality rate was 0.02%. THR was performed in 680 patients (10.6%) at a mean of 1.4 years after the index operation, and 286 patients (4.5%) underwent revision hip arthroscopy at a mean of 1.7 years. Kaplan-Meier survival analysis showed an 8-year survival rate of 82.6% (95% confidence interval [CI], 80.9% to 84.2%), whereas Cox proportional hazard analysis adjusting for age, gender, and Charlson comorbidity score showed an 8-year survival rate of 86%. Female patients had a 1.68 times (95% CI, 1.41 to 2.01) higher risk of conversion to THR than male patients, and patients aged 50 years or older had a 4.65 (95% CI, 3.93 to 5.49) times higher risk of requiring hip replacement than patients younger than 50 years.
In this large series of 6,395 hip arthroscopies looking at the national data from the English National Health Service, our null hypothesis has been supported, and we have determined that the rate of short-term complications, in particular the risk of DVT and PE after this operation, is low. Higher age and female gender are significant predictors of conversion to THR, with Cox proportional hazard analyses showing a survivorship rate of 86% at 8 years after adjustment for confounding variables.
Level IV, therapeutic case series.
我们的研究旨在确定髋关节镜手术的并发症，尤其着重于30天再入院率；90天深静脉血栓形成（DVT）和肺栓塞（PE）率以及死亡率；髋关节镜翻修率；特别是以转为全髋关节置换术（THR）作为终点的生存率。
使用ICD - 10（国际疾病及相关健康问题统计分类，第10版）和OPCS - 4（人口普查与调查办公室外科手术和程序分类，第4版）编码，从涵盖英格兰国家医疗服务体系医院所有入院病例的医院管理入院数据库中提取接受髋关节镜手术患者的记录。
研究期间共纳入6395例髋关节镜手术。30天再入院率为0.5%；90天DVT率和PE率均为0.08%；90天死亡率为0.02%。680例患者（10.6%）在初次手术后平均1.4年接受了THR，286例患者（4.5%）在初次手术后平均1.7年接受了髋关节镜翻修术。Kaplan - Meier生存分析显示8年生存率为82.6%（95%置信区间[CI]，80.9%至84.2%），而经年龄、性别和Charlson合并症评分调整的Cox比例风险分析显示8年生存率为86%。女性患者转为THR的风险是男性患者的1.68倍（95% CI，1.41至2.01），50岁及以上患者需要进行髋关节置换的风险是50岁以下患者的4.65倍（95% CI，3.93至5.49）。
在这一基于英格兰国家医疗服务体系全国数据的6395例大型髋关节镜手术系列研究中，我们的零假设得到了支持，并且我们确定短期并发症发生率，尤其是该手术后DVT和PE的风险较低。年龄较大和女性是转为THR的重要预测因素，经Cox比例风险分析调整混杂变量后显示8年生存率为86%。
IV级，治疗性病例系列。
