Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, U.S.A..
Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, U.S.A.
Arthroscopy. 2023 Jul;39(7):1639-1648. doi: 10.1016/j.arthro.2023.01.100.
To evaluate 90-day complications, 5-year secondary surgery rates, and risk factors for secondary surgery following primary hip arthroscopy performed for femoroacetabular impingement and/or labral tears using a large national dataset.
A retrospective analysis was conducted using the PearlDiver Mariner151 database. Patients with International Classification of Diseases, Tenth Revision, diagnosis codes for femoroacetabular impingement and/or labral tear undergoing primary hip arthroscopy with femoroplasty, acetabuloplasty, and/or labral repair between 2015 and 2021 were identified. Those with concomitant International Classification of Diseases, Tenth Revision, codes for infection, neoplasm, or fracture were excluded, as were patients with a history of previous hip arthroscopy or total hip arthroplasty, or age ≥70 years. Rates of complications within 90 days of surgery were assessed. Five-year rates of secondary surgery-revision hip arthroscopy or conversion to total hip arthroplasty-were determined by Kaplan-Meier analysis, and risk factors for secondary surgery were identified by multivariate logistic regression.
A total of 31,623 patients underwent primary hip arthroscopy from October 2015 to April 2021, with annual volumes ranging from 5,340 to 6,343 surgeries per year. Femoroplasty was the most frequent surgical procedure (performed in 81.1% of surgical encounters), followed by labral repair (72.6%) and acetabuloplasty (33.0%). Ninety-day postoperative complication rates were low, with 1.28% of patients experiencing any complication. The 5-year secondary surgery rate was 4.9% (N = 915 patients). Multivariate logistic regression identified age <20 years (odds ratio [OR] 1.50; P < .001), female sex (OR 1.33; P < .001), class I obesity (body mass index 30-34.9: OR 1.30; P = .04), and class II/III obesity (body mass index ≥35.0: OR 1.29; P = .02) as independent predictors of secondary surgery.
In this study of primary hip arthroscopy, 90-day adverse events were low at 1.28%, and the 5-year secondary surgery rate was 4.9%. Age younger than 20 years, female sex, and obesity were risk factors for secondary surgery, suggesting the need for increased surveillance in these patient groups.
Level IV, case series.
使用大型国家数据库评估因股骨髋臼撞击症和/或盂唇撕裂而行初次髋关节镜检查后 90 天内的并发症、5 年二次手术率以及二次手术的风险因素。
使用 PearlDiver Mariner151 数据库进行回顾性分析。确定了 2015 年至 2021 年间接受过股骨成形术、髋臼成形术和/或盂唇修复术的因股骨髋臼撞击症和/或盂唇撕裂而接受初次髋关节镜检查的国际疾病分类，第十版诊断代码的患者。排除伴有国际疾病分类，第十版感染、肿瘤或骨折编码的患者，以及既往髋关节镜检查或全髋关节置换术病史或年龄≥70 岁的患者。评估手术 90 天内并发症的发生率。通过 Kaplan-Meier 分析确定 5 年的二次手术（翻修髋关节镜检查或转换为全髋关节置换术）率，并通过多变量逻辑回归确定二次手术的风险因素。
共有 31623 名患者于 2015 年 10 月至 2021 年 4 月期间接受初次髋关节镜检查，每年手术量为 5340 至 6343 例。最常见的手术是股骨成形术（占手术的 81.1%），其次是盂唇修复术（72.6%）和髋臼成形术（33.0%）。90 天后的术后并发症发生率较低，仅有 1.28%的患者发生任何并发症。5 年的二次手术率为 4.9%（N=915 例）。多变量逻辑回归确定年龄<20 岁（比值比[OR]1.50；P<.001）、女性（OR 1.33；P<.001）、I 级肥胖（体重指数 30-34.9：OR 1.30；P=.04）和 II/III 级肥胖（体重指数≥35.0：OR 1.29；P=.02）是二次手术的独立预测因素。
在这项初次髋关节镜检查的研究中，90 天内不良事件发生率为 1.28%，5 年二次手术率为 4.9%。年龄<20 岁、女性和肥胖是二次手术的危险因素，提示需要对这些患者群体进行更密切的监测。
IV 级，病例系列研究。
