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髋关节镜检查失败率:美国医疗保健数据库分析

Hip arthroscopy failure rates: a healthcare database analysis in the United States.

作者信息

Thakkar Akshar P, Scheidt Michael D, Jadidi Shaheen, Ellman Michael B, Bare Aaron A, Stover Michael D, Bhatia Sanjeev

机构信息

Hip & Knee Joint Preservation Center, Department of Orthopaedics, Northwestern Medicine, 27650 Ferry Road, Warrenville, IL 60555, United States.

Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, 420 East Superior Street, Chicago, IL 60611, United States.

出版信息

J Hip Preserv Surg. 2024 Nov 26;12(1):3-10. doi: 10.1093/jhps/hnae036. eCollection 2025 Jan.

Abstract

With hip arthroscopy cases, there has been a concomitant increase in complications and the need for revision surgery. This study aims to further contribute to the literature regarding hip arthroscopy failure rates and associated patient factors following an index hip arthroscopy procedure. The PearlDiver database was queried for patients who had undergone hip arthroscopy. International Classification of Diseases, 10th Revision, Clinical Modification codes were used to ensure that follow-up was performed on the ipsilateral limb. Hip arthroscopy failure was defined specifically as subsequent ipsilateral total hip arthroplasty (THA) and reoperation, which were examined in all patients that met inclusion criteria. Independent patient variables, including psychiatric comorbidities, preoperative SSRI use, smoking, and obesity, were examined to identify an association with failure rates. A Student -test, with a significance set at  < 0.05, was used for statistical comparisons of postoperative outcomes. Odds ratios were used to calculate the probability of short-term hip reoperation in patients with the above independent variables. A total of 19 067 hip arthroscopy patients were included in this study. Within 2 years from the index hip arthroscopy, there was an 11.42% failure rate as defined by subsequent reoperation and 7.16% failure rate as defined by revision to THA, with a total revision surgery rate of 18.58%. The most common reoperation procedure was revision femoroplasty (72%). Patients with an active diagnosis of a psychiatric comorbidity in the year leading up to a hip arthroscopy procedure were 1.74 times more likely to require a hip reoperation within 1 year (95% CI, 1.55-1.95).

摘要

随着髋关节镜手术病例的增加,并发症以及翻修手术的需求也随之增加。本研究旨在进一步丰富有关初次髋关节镜手术后失败率及相关患者因素的文献资料。在PearlDiver数据库中查询接受过髋关节镜手术的患者。使用国际疾病分类第10版临床修订本代码以确保对同侧肢体进行随访。髋关节镜手术失败具体定义为随后进行同侧全髋关节置换术(THA)和再次手术,对所有符合纳入标准的患者进行检查。研究独立的患者变量,包括精神疾病合并症、术前使用选择性5-羟色胺再摄取抑制剂(SSRI)、吸烟和肥胖,以确定与失败率的关联。采用显著性设定为<0.05的Student检验对术后结果进行统计学比较。使用比值比来计算具有上述独立变量的患者短期髋关节再次手术的概率。本研究共纳入19067例髋关节镜手术患者。在初次髋关节镜手术后2年内,再次手术定义的失败率为11.42%,翻修为THA定义的失败率为7.16%,总翻修手术率为18.58%。最常见的再次手术是股骨成形术翻修(72%)。在进行髋关节镜手术前一年被确诊患有精神疾病合并症的患者在1年内进行髋关节再次手术的可能性高1.74倍(95%CI,1.55 - 1.95)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6225/12051859/2c4982fc9154/hnae036f1.jpg

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