Abhinaba Chatterjee, Kaisen Yao, Matthew H Nasra, Thun Itthipanichpong, Gregory Galano, Anil S Ranawat
{"title":"有腰椎融合术病史的患者在初次髋关节镜手术后进行关节镜翻修和转为全髋关节置换术的风险较高。","authors":"Abhinaba Chatterjee, Kaisen Yao, Matthew H Nasra, Thun Itthipanichpong, Gregory Galano, Anil S Ranawat","doi":"10.1016/j.arthro.2024.08.026","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To characterize the risk of revision hip arthroscopy or conversion to total hip arthroplasty (THA) among patients with a history of lumbar fusion undergoing primary hip arthroscopy.</p><p><strong>Methods: </strong>We used the Statewide Planning and Research Cooperative System, an administrative database including all ambulatory and inpatient surgery encounters in New York (NY), to identify all patients who underwent hip arthroscopy for FAI between 2010-2020. Patients with prior lumbar fusion were identified using CPT and ICD 9th/10th Revision coding definitions. Patients with and without prior fusion were matched in a 1:5 ratio according to age and comorbidity burden. The number of levels fused was defined in the following fashion: i) no fusion, ii) 1-2 levels, or iii) ≥3 levels. Patients were followed for two years to evaluate the rate of revision hip arthroscopy or conversion to THA. Multivariable logistic regression models were used to measure the association between number of levels fused and revision hip arthroscopy or conversion to THA.</p><p><strong>Results: </strong>Between 2010-2020, there were 23,277 patients that underwent primary hip arthroscopy in NY state. Of these, 348 (1.4%) had a prior lumbar fusion. After matching for age and comorbidities, the composite rate of revision hip arthroscopy or conversion to THA was higher in patients with prior lumbar fusion compared to patients without (16.5% vs. 8.5%; P < 0.001). This risk increased with the number of levels fused (1-2 levels: 15.1%; aOR, 1.8; 95% CI, 1.3-2.6; vs. ≥3 levels: 26.3%; aOR, 3.4; 95% CI, 1.7-7.0).</p><p><strong>Conclusion: </strong>Patients with a history of lumbar fusion had significantly higher rates of revision hip arthroscopy and conversion to THA compared to patients without prior fusion. The risk of revision hip arthroscopy or conversion to THA was increased approximately 2-fold in patients with 1-2 levels fused and 3-fold in patients with 3 or more levels fused.</p><p><strong>Level of evidence: </strong>Level III, prognostic retrospective matched comparative case series.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4000,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Patients with a history of lumbar fusion have a higher risk of revision arthroscopy and conversion to total hip arthroplasty after primary hip arthroscopy.\",\"authors\":\"Abhinaba Chatterjee, Kaisen Yao, Matthew H Nasra, Thun Itthipanichpong, Gregory Galano, Anil S Ranawat\",\"doi\":\"10.1016/j.arthro.2024.08.026\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To characterize the risk of revision hip arthroscopy or conversion to total hip arthroplasty (THA) among patients with a history of lumbar fusion undergoing primary hip arthroscopy.</p><p><strong>Methods: </strong>We used the Statewide Planning and Research Cooperative System, an administrative database including all ambulatory and inpatient surgery encounters in New York (NY), to identify all patients who underwent hip arthroscopy for FAI between 2010-2020. Patients with prior lumbar fusion were identified using CPT and ICD 9th/10th Revision coding definitions. Patients with and without prior fusion were matched in a 1:5 ratio according to age and comorbidity burden. The number of levels fused was defined in the following fashion: i) no fusion, ii) 1-2 levels, or iii) ≥3 levels. Patients were followed for two years to evaluate the rate of revision hip arthroscopy or conversion to THA. Multivariable logistic regression models were used to measure the association between number of levels fused and revision hip arthroscopy or conversion to THA.</p><p><strong>Results: </strong>Between 2010-2020, there were 23,277 patients that underwent primary hip arthroscopy in NY state. Of these, 348 (1.4%) had a prior lumbar fusion. After matching for age and comorbidities, the composite rate of revision hip arthroscopy or conversion to THA was higher in patients with prior lumbar fusion compared to patients without (16.5% vs. 8.5%; P < 0.001). This risk increased with the number of levels fused (1-2 levels: 15.1%; aOR, 1.8; 95% CI, 1.3-2.6; vs. ≥3 levels: 26.3%; aOR, 3.4; 95% CI, 1.7-7.0).</p><p><strong>Conclusion: </strong>Patients with a history of lumbar fusion had significantly higher rates of revision hip arthroscopy and conversion to THA compared to patients without prior fusion. The risk of revision hip arthroscopy or conversion to THA was increased approximately 2-fold in patients with 1-2 levels fused and 3-fold in patients with 3 or more levels fused.</p><p><strong>Level of evidence: </strong>Level III, prognostic retrospective matched comparative case series.</p>\",\"PeriodicalId\":55459,\"journal\":{\"name\":\"Arthroscopy-The Journal of Arthroscopic and Related Surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.4000,\"publicationDate\":\"2024-08-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Arthroscopy-The Journal of Arthroscopic and Related Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.arthro.2024.08.026\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.arthro.2024.08.026","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Patients with a history of lumbar fusion have a higher risk of revision arthroscopy and conversion to total hip arthroplasty after primary hip arthroscopy.
Purpose: To characterize the risk of revision hip arthroscopy or conversion to total hip arthroplasty (THA) among patients with a history of lumbar fusion undergoing primary hip arthroscopy.
Methods: We used the Statewide Planning and Research Cooperative System, an administrative database including all ambulatory and inpatient surgery encounters in New York (NY), to identify all patients who underwent hip arthroscopy for FAI between 2010-2020. Patients with prior lumbar fusion were identified using CPT and ICD 9th/10th Revision coding definitions. Patients with and without prior fusion were matched in a 1:5 ratio according to age and comorbidity burden. The number of levels fused was defined in the following fashion: i) no fusion, ii) 1-2 levels, or iii) ≥3 levels. Patients were followed for two years to evaluate the rate of revision hip arthroscopy or conversion to THA. Multivariable logistic regression models were used to measure the association between number of levels fused and revision hip arthroscopy or conversion to THA.
Results: Between 2010-2020, there were 23,277 patients that underwent primary hip arthroscopy in NY state. Of these, 348 (1.4%) had a prior lumbar fusion. After matching for age and comorbidities, the composite rate of revision hip arthroscopy or conversion to THA was higher in patients with prior lumbar fusion compared to patients without (16.5% vs. 8.5%; P < 0.001). This risk increased with the number of levels fused (1-2 levels: 15.1%; aOR, 1.8; 95% CI, 1.3-2.6; vs. ≥3 levels: 26.3%; aOR, 3.4; 95% CI, 1.7-7.0).
Conclusion: Patients with a history of lumbar fusion had significantly higher rates of revision hip arthroscopy and conversion to THA compared to patients without prior fusion. The risk of revision hip arthroscopy or conversion to THA was increased approximately 2-fold in patients with 1-2 levels fused and 3-fold in patients with 3 or more levels fused.
Level of evidence: Level III, prognostic retrospective matched comparative case series.
期刊介绍：
Nowhere is minimally invasive surgery explained better than in Arthroscopy, the leading peer-reviewed journal in the field. Every issue enables you to put into perspective the usefulness of the various emerging arthroscopic techniques. The advantages and disadvantages of these methods -- along with their applications in various situations -- are discussed in relation to their efficiency, efficacy and cost benefit. As a special incentive, paid subscribers also receive access to the journal expanded website.
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