Assessing Venous Thromboembolism Risk in Hip Arthroscopy: A Propensity-matched Comparison of Adolescents and Adults.

Background: Hip arthroscopy is a commonly performed procedure in adolescents with hip pathology. However, there is limited data on venous thromboembolism (VTE) events in this population, resulting in minimal guidance on appropriate VTE prophylaxis, with the bulk of current guidance extrapolated from the adult population. Therefore, this study aims to assess overall rates of VTE in the adolescent population as well as compare these rates to a matched cohort of adult patients undergoing hip arthroscopy.

Methods: This retrospective cohort study drew data from the TriNetX platform between January 1, 2003 and March 1, 2024. Adolescent patients, ages 13 to 18, were matched to adult patients (19 and older) undergoing hip arthroscopy, accounting for sex, tobacco use, oral contraceptive use, diabetes mellitus, and overweight/obesity. Outcomes of interest were deep vein thrombosis (DVT) or pulmonary embolism (PE) within 90 days after the procedure. Overall rates were calculated and compared between cohorts. Statistical significance was set at P <0.01.

Results: A total of 3655 patients were successfully matched with a mean age of 16 in the adolescent cohort and 35 in the adult cohort. The overall rates of DVT were similar between cohorts, at 1% for adolescent patients and 0.9% for adults (RR: 0.892; 95% CI: 0.559-1.423; P =0.63). All VTE events (combined DVT and PE) were also similar at 1.1% for adolescent patients and 1.0% in adults (RR: 0.925; 95% CI: 0.593-1.443; P =0.73).

Conclusion: This study found no significant difference in VTE between adolescent and adult patients undergoing hip arthroscopy. The overall rate of VTE was relatively high in adolescent patients, at 1.1%, suggesting additional attention to VTE and potential chemoprophylaxis may be warranted in select patients.

Level of evidence: Level III-case-control study or retrospective cohort study.