{"title":"Direct anterior total hip arthroplasty after hip arthroscopy: A retrospective review","authors":"Matthew Pate , Joshua Gira , Carl Wierks","doi":"10.1016/j.jor.2025.01.017","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Limited studies have investigated outcomes of total hip arthroplasty (THA) after ipsilateral hip arthroscopy, with mixed conclusions. There is need to provide clarity on potential risks/complications associated with this sequence of operations.</div></div><div><h3>Methods</h3><div>This is a retrospective single surgeon cohort study, evaluating patients from 01/01/2012–01/01/2020 undergoing direct anterior THA for osteoarthritis, with minimum 90-day follow-up. There were two groups: previous hip arthroscopy plus THA (THA+) and isolated THA (control) without previous hip arthroscopy. All THA + patients had undergone one previous hip arthroscopy prior to THA. Quantitative variables were evaluated using the Mann-Whitney-U test or a two-tailed unpaired <em>t</em>-test. Nominal variables were evaluated using the chi-square or Fisher's Exact test. Significance was assessed at p < 0.05.</div></div><div><h3>Results</h3><div>Seventy-one patients were included, 38 patients in the THA + group, and 33 patients in the control group. Surgery duration was longer in the THA + group (74 min THA + [SD = 9.5], 60 min control [SD = 11.3], p < 0.0001). The only secondary outcome with significance was average estimated blood loss (400 mL THA+, 275 mL control, p = 0.009). Only one THA + patient required postoperative transfusion (p = 1.0). There were no postoperative deep infections requiring debridement, intra-operative fractures requiring fixation, or postoperative dislocations in either group. The THA group had one post-operative fracture requiring surgery. The THA + group was younger (average) than the control group (52 THA + [SD = 9.9], 58.4 control [SD = 8.8], p = 0.0062).</div></div><div><h3>Conclusion</h3><div>This study highlights increased operative time and estimated blood loss after previous ipsilateral hip arthroscopy. Surgeons should recognize implications on time management, and assist surgeons when deciding to perform a THA at a surgery center vs hospital. These results contribute to a growing body of literature indicating no increase in major complication rate of THA after ipsilateral hip arthroscopy.</div></div>","PeriodicalId":16633,"journal":{"name":"Journal of orthopaedics","volume":"68 ","pages":"Pages 68-71"},"PeriodicalIF":1.5000,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of orthopaedics","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0972978X25000170","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction
Limited studies have investigated outcomes of total hip arthroplasty (THA) after ipsilateral hip arthroscopy, with mixed conclusions. There is need to provide clarity on potential risks/complications associated with this sequence of operations.
Methods
This is a retrospective single surgeon cohort study, evaluating patients from 01/01/2012–01/01/2020 undergoing direct anterior THA for osteoarthritis, with minimum 90-day follow-up. There were two groups: previous hip arthroscopy plus THA (THA+) and isolated THA (control) without previous hip arthroscopy. All THA + patients had undergone one previous hip arthroscopy prior to THA. Quantitative variables were evaluated using the Mann-Whitney-U test or a two-tailed unpaired t-test. Nominal variables were evaluated using the chi-square or Fisher's Exact test. Significance was assessed at p < 0.05.
Results
Seventy-one patients were included, 38 patients in the THA + group, and 33 patients in the control group. Surgery duration was longer in the THA + group (74 min THA + [SD = 9.5], 60 min control [SD = 11.3], p < 0.0001). The only secondary outcome with significance was average estimated blood loss (400 mL THA+, 275 mL control, p = 0.009). Only one THA + patient required postoperative transfusion (p = 1.0). There were no postoperative deep infections requiring debridement, intra-operative fractures requiring fixation, or postoperative dislocations in either group. The THA group had one post-operative fracture requiring surgery. The THA + group was younger (average) than the control group (52 THA + [SD = 9.9], 58.4 control [SD = 8.8], p = 0.0062).
Conclusion
This study highlights increased operative time and estimated blood loss after previous ipsilateral hip arthroscopy. Surgeons should recognize implications on time management, and assist surgeons when deciding to perform a THA at a surgery center vs hospital. These results contribute to a growing body of literature indicating no increase in major complication rate of THA after ipsilateral hip arthroscopy.
期刊介绍:
Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.