Bolarinwa Surajudeen A, Aryee Jomar N, Labaran Lawal A, Werner Brian C, Browne James A
Department of Orthopaedic Surgery, School of Medicine, University of Virginia, Charlottesville, VA, USA.
Hip Pelvis. 2020 Mar;32(1):35-41. doi: 10.5371/hp.2020.32.1.35. Epub 2020 Feb 26.
Arthroscopy for repair of femoroacetabular impingement (FAI) and related conditions is technically challenging, but remains the preferred approach for management of these hip pathologies. The incidence of this procedure has increased steadily for the past few years, but little is known about its potential long-term effects on future interventions. The purpose of this study was to evaluate whether prior arthroscopic correction of FAI pathology impacts postoperative complication rates in patients receiving subsequent ipsilateral total hip arthroplasty (THA) on a national scale.
A commercially available national database - PearlDiver Patients Records Database - identified primary THA patients from 2005 to 2014. Patients who had prior arthroscopic FAI repair (post arthroscopy group) were separated from those who did not (native hip group). Prior FAI repair was examined as a risk factor for complications following THA and a multivariable logistic regression analysis was applied to identify risk factors for complications following THA.
A total of 11,061 patients met all inclusion and exclusion criteria; 10,951 in the native hip group and 110 in the post arthroscopy group. Prior FAI repair was not significantly associated with higher rates of 90-day readmission (=0.585), aseptic dislocation/revision within 3 years (=0.409), surgical site infection within 3 years (=0.796), or hip stiffness within 3 years (=0.977) after THA.
Arthroscopic FAI repair is not an independent risk factor for complications following subsequent ipsilateral THA (level of evidence: III).
关节镜下修复股骨髋臼撞击症(FAI)及相关病症在技术上具有挑战性,但仍是治疗这些髋关节病变的首选方法。在过去几年中,该手术的发生率稳步上升,但对于其对未来干预措施的潜在长期影响知之甚少。本研究的目的是在全国范围内评估先前关节镜下矫正FAI病变是否会影响接受同侧全髋关节置换术(THA)患者的术后并发症发生率。
使用一个商业性的全国数据库——PearlDiver患者记录数据库,识别出2005年至2014年的初次THA患者。将先前接受过关节镜下FAI修复的患者(关节镜检查后组)与未接受过的患者(原生髋关节组)分开。将先前的FAI修复作为THA后并发症的危险因素进行检查,并应用多变量逻辑回归分析来确定THA后并发症的危险因素。
共有11,061名患者符合所有纳入和排除标准;原生髋关节组10,951名,关节镜检查后组110名。先前的FAI修复与THA后90天再入院率(=0.585)、3年内无菌性脱位/翻修率(=0.409)、3年内手术部位感染率(=0.796)或3年内髋关节僵硬率(=0.977)的升高无显著相关性。
关节镜下FAI修复不是同侧后续THA后并发症的独立危险因素(证据级别:III)。