West Christopher R, Bedard Nicholas A, Duchman Kyle R, Westermann Robert W, Callaghan John J
University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, Iowa, 52242.
Iowa Orthop J. 2019;39(1):95-99.
Revision hip arthroscopy often serves as a measure for a failed primary hip arthroscopy procedure. The purpose of this study was to examine the rate, timing, and risk factors for revision hip arthroscopy using a large national database.
The Humana administrative claims dataset was reviewed from 2007 through the second quarter of 2015 to identify patients undergoing hip arthroscopy using Current Procedural Terminology (CPT) codes and laterality modifiers. Patients with subsequent ipsilateral revision hip arthroscopy were identified and the rate and timing of these revisions determined. Subgroup analysis was performed to determine effects of gender, age, body mass index (BMI), osteoarthritis diagnosis, and specific hip arthroscopy procedure on revision rates.
There were 1807 hip arthroscopy procedures identified with a revision rate of 4% (total of 72 procedures). Of the revision procedures, 43% occurred within 6 months after the index procedure, and 86% occurred within 18 months. Age < 50 years was the only significant predictor of revision hip arthroscopy (OR 2.03, CI 1.173.53) with an even distribution across younger age groups. An osteoarthritis diagnosis, gender, and BMI did not represent significant risk factors for revision (OR 0.87, 0.98, 0.9 and CI 0.5-1.51, CI 0.6-1.59, CI 0.37-2.12, respectively). Chondroplasty was the most common procedure leading to revision (46%) followed by labral repair (37%). The most common revision procedures were chondroplasty (44%) followed by femoroplasty (38%).
Overall, 4% of hip arthroscopy procedures underwent revision arthroscopy over the 8-year period. Revision was associated with age < 50, and revisions were most frequently performed for femoroacetabular impingement. The majority of revisions occurred within 18 months after the index procedure. IV.
翻修髋关节镜检查通常是针对初次髋关节镜手术失败的一种措施。本研究的目的是利用一个大型国家数据库来研究翻修髋关节镜检查的发生率、时间及危险因素。
回顾2007年至2015年第二季度的Humana行政索赔数据集，以使用当前操作术语（CPT）编码和侧别修饰符来识别接受髋关节镜检查的患者。确定随后进行同侧翻修髋关节镜检查的患者，并确定这些翻修的发生率和时间。进行亚组分析以确定性别、年龄、体重指数（BMI）、骨关节炎诊断及特定髋关节镜手术对翻修率的影响。
共识别出1807例髋关节镜手术，翻修率为4%（共72例手术）。在翻修手术中，43%发生在初次手术后6个月内，86%发生在18个月内。年龄＜50岁是翻修髋关节镜检查的唯一显著预测因素（OR 2.03，CI 1.17 - 3.53），在较年轻年龄组中分布均匀。骨关节炎诊断、性别和BMI并非翻修的显著危险因素（OR分别为0.87、0.98、0.9，CI分别为0.5 - 1.51、0.6 - 1.59、0.37 - 2.12）。软骨成形术是导致翻修的最常见手术（46%），其次是盂唇修复（37%）。最常见的翻修手术是软骨成形术（44%），其次是股骨成形术（38%）。
总体而言，在8年期间，4%的髋关节镜手术接受了翻修关节镜检查。翻修与年龄＜50岁相关，且翻修最常因股骨髋臼撞击症进行。大多数翻修发生在初次手术后18个月内。
