Total Hip Arthroplasty After Hip Arthroscopy Has Increased Complications and Revision Risk

J Arthroplasty. 2021 Dec;36(12):3922-3927.e2. doi: 10.1016/j.arth.2021.07.020. Epub 2021 Aug 4.

Abstract

Background: 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.

Methods: 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 .

Results: 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.

Conclusion: Patients undergoing THA after HA are at an increased risk for surgical complications, as well as the need for revision surgery.

Keywords: complications; conversion total hip arthroplasty; hip arthroscopy; revision hip; total hip arthroplasty.

MeSH terms

  • Arthroplasty, Replacement, Hip* / adverse effects
  • Arthroscopy
  • Humans
  • Joint Dislocations*
  • Odds Ratio
  • Postoperative Complications / epidemiology
  • Reoperation
  • Retrospective Studies
  • Risk Factors