Department of Orthopaedics Warren Alpert Medical School of Brown University, Providence, RI.
J Arthroplasty. 2021 Dec;36(12):3922-3927.e2. doi: 10.1016/j.arth.2021.07.020. Epub 2021 Aug 4.
There has been an increase in hip arthroscopy (HA) over the last decade. After HA, some patients may ultimately require a total hip arthroplasty (THA). However, there is a scarcity of research investigating the outcomes in patients undergoing THA with a history of ipsilateral HA.
The PearlDiver research program (www.pearldiverinc.com) was queried to capture all patients undergoing THA between 2015 and 2020. Propensity matching was performed to match patients undergoing THA with and without a history of ipsilateral THA. Rates of 30-day medical complications, 1-year surgical complications, and THA revision were compared using multivariate logistic regression. Kaplan-Meier analysis was conducted to estimate survival probabilities of each of the groups with patients undergoing THA .
After propensity matching, cohorts of 1940 patients undergoing THA without prior HA and 1940 patients undergoing a THA with prior HA were isolated for analysis. The mean time from HA to THA was 1127 days (standard deviation 858). Patients with a history of ipsilateral HA had an increased risk for dislocation (odds ratio [OR] 1.56, P = .03) and overall decreased implant survival within 4 years of undergoing THA (OR 1.53; P = .05). Furthermore, our data demonstrate the timing of previous HA to be associated with the risk of complications, as illustrated by the increased risk for dislocation (OR 1.75, P = .03), aseptic loosening (OR 2.18, P = .03), and revision surgery at 2 (OR 1.92, P = .02) and 4 years (OR 2.05, P = .01) in patients undergoing THA within 1 year of HA compared twitho patients undergoing THA more than 1 year after HA or with no previous history of HA.
Patients undergoing THA after HA are at an increased risk for surgical complications, as well as the need for revision surgery.
在过去十年中，髋关节镜检查（HA）的数量有所增加。HA 后，一些患者最终可能需要进行全髋关节置换术（THA）。然而，对于有 HA 病史的患者进行 THA 的结果研究相对较少。
通过 PearlDiver 研究计划（www.pearldiverinc.com）查询了 2015 年至 2020 年间所有接受 THA 的患者。采用倾向匹配的方法，对接受和未接受同侧 HA 的 THA 患者进行匹配。使用多变量逻辑回归比较了 30 天内医疗并发症、1 年手术并发症和 THA 翻修的发生率。Kaplan-Meier 分析用于估计每组接受 THA 的患者的生存率。
经过倾向匹配，分离出了 1940 例无 HA 病史的 THA 患者和 1940 例有 HA 病史的 THA 患者进行分析。HA 到 THA 的平均时间为 1127 天（标准差 858）。有 HA 病史的患者发生脱位的风险增加（比值比 [OR] 1.56，P=0.03），并且在接受 THA 后 4 年内植入物的总体存活率降低（OR 1.53；P=0.05）。此外，我们的数据表明，先前 HA 的时间与并发症风险相关，如图所示，在 HA 后 1 年内接受 THA 的患者发生脱位的风险增加（OR 1.75，P=0.03）、无菌性松动的风险增加（OR 2.18，P=0.03）和翻修手术的风险增加（OR 1.92，P=0.02）和 4 年（OR 2.05，P=0.01），与 HA 后 1 年以上接受 THA 或无先前 HA 病史的患者相比。
HA 后接受 THA 的患者发生手术并发症和需要翻修手术的风险增加。
