髋关节镜检查的并发症发生率被低估：一项基于人群的研究。
Complication Rates for Hip Arthroscopy Are Underestimated: A Population-Based Study.
作者信息
Truntzer Jeremy N, Hoppe Daniel J, Shapiro Lauren M, Abrams Geoffrey D, Safran Marc
机构信息
Department of Orthopaedics, Stanford University Hospitals, Redwood City, California, U.S.A..
Department of Orthopaedics, Stanford University Hospitals, Redwood City, California, U.S.A.
出版信息
Arthroscopy. 2017 Jun;33(6):1194-1201. doi: 10.1016/j.arthro.2017.01.021. Epub 2017 Mar 1.
PURPOSE
To identify major and minor complication rates associated with hip arthroscopy from a payer-based national database and compare with the rates reported in the existing literature.
METHODS
Patients who underwent hip arthroscopy between 2007 and 2014 were identified using PearlDiver, a publicly available database. Rates of major and minor complications, as well as conversion to total hip arthroscopy (THA), were determined by using Current Procedural Terminology (CPT) and International Classification of Diseases, Ninth Revision (ICD-9), codes. Incidence rates of select major complications across the entire database were used as a comparison group. Statistical significance was set at P < .05.
RESULTS
Of 18 million patients screened from 2007 to 2014, a total of 2,581 hip arthroscopies were identified. The rates of major and minor complications within a 1-year postoperative period were 1.74% and 4.22%, respectively. Complications included heterotopic ossification (2.85%), bursitis (1.23%), proximal femur fracture (1.08%), deep vein thrombosis (0.79%), and hip dislocation (0.58%). The rate of conversion to THA within 1 year was 2.85%. When compared to rates in the general population, the relative risks [RRs] of requiring a THA (age <50 years, RR = 57.66, P < .001; age >50 years, RR = 22.05, P < .001), sustaining a proximal femur fracture (age <50 years, RR = 18.02, P < .001; age >50 years, RR = 2.23, P < .001), or experiencing a hip dislocation (RR 19.60, P < .001) at 1 year after hip arthroscopy were significantly higher in all age groups.
CONCLUSIONS
Higher major complication rates after hip arthroscopy were observed using a national payer-based database than previously reported in the literature, especially in regard to hip dislocations and proximal femur fractures. Rates of total hip arthroplasty were similar to prior studies, whereas the rates of revision hip arthroscopy were higher.
LEVEL OF EVIDENCE
Level IV, case series.
目的
从一个基于医保支付方的全国性数据库中确定与髋关节镜检查相关的主要和次要并发症发生率，并与现有文献报道的发生率进行比较。
方法
使用公开可用的PearlDiver数据库识别2007年至2014年间接受髋关节镜检查的患者。主要和次要并发症的发生率，以及转为全髋关节置换术（THA）的发生率，通过使用当前手术操作术语（CPT）和国际疾病分类第九版（ICD-9）编码来确定。将整个数据库中选定主要并发症的发生率用作比较组。统计学显著性设定为P < 0.05。
结果
在2007年至2014年间筛查的1800万患者中，共识别出2581例髋关节镜检查病例。术后1年内主要和次要并发症的发生率分别为1.74%和4.22%。并发症包括异位骨化（2.85%）、滑囊炎（1.23%）、股骨近端骨折（1.08%）、深静脉血栓形成（0.79%）和髋关节脱位（0.58%）。1年内转为THA的发生率为2.85%。与一般人群的发生率相比，髋关节镜检查后1年需要进行THA（年龄<50岁，RR = 57.66，P < 0.001；年龄>50岁，RR = 22.05，P < 0.001）、发生股骨近端骨折（年龄<50岁，RR = 18.02，P < 0.001；年龄>50岁，RR = 2.23，P < 0.001）或髋关节脱位（RR = 19.60，P < 0.001）的相对风险在所有年龄组中均显著更高。
结论
使用基于医保支付方的全国性数据库观察到，髋关节镜检查后的主要并发症发生率高于先前文献报道，尤其是在髋关节脱位和股骨近端骨折方面。全髋关节置换术的发生率与先前研究相似，而髋关节镜翻修术的发生率更高。
证据级别
IV级，病例系列。
Zotero 插件