The Journal of Hip Surgery 2018; 02(03): 148-154
DOI: 10.1055/s-0038-1673374
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Increasing Age Is Not Independently Associated with Increased 30-Day Morbidity after Hip Arthroscopy

Venkat Boddapati
1   Department of Orthopaedic Surgery, Columbia University Medical Center, New York, New York
,
Jamie Confino
1   Department of Orthopaedic Surgery, Columbia University Medical Center, New York, New York
,
Michael C. Fu
2   Department of Orthopaedic Surgery, Hospital for Special Surgery New York, New York
,
Kyle R. Duchman
3   Department of Orthopaedic Surgery and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa
,
Robert W. Westermann
3   Department of Orthopaedic Surgery and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa
,
T. Sean Lynch
1   Department of Orthopaedic Surgery, Columbia University Medical Center, New York, New York
› Author Affiliations
Further Information

Publication History

02 July 2018

14 August 2018

Publication Date:
05 October 2018 (online)

Abstract

The purpose of this study is to examine the 30-day postoperative complications after hip arthroscopy as a function of patient age. The American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2016 was used to identify all patients undergoing hip arthroscopy using Current Procedural Terminology and International Classification of Disease codes. Patient characteristics and postoperative complications were compared in a retrospective cohort study with a level of evidence 3 across patient age cohorts using bivariate and multivariate analysis that corrected for differences in baseline patient characteristics. In total, 2,427 patients undergoing hip arthroscopy were identified. Of all identified patients, 667 (27.5%) were under 30 years of age, 596 (24.5%) were between 31 and 40, 599 (24.6%) were between 41 and 50, and 566 (23.3%) were older than 50. Chondroplasty, abrasion arthroplasty, and/or resection of the labrum were the most commonly performed procedures in all age groups. As age increased, patients were more likely to be female and have a higher body mass index, more medical comorbidities, a shorter operative duration, and a higher American Society of Anesthesiologists class. The rate of any 30-day postoperative complication was 1.35% in patients under 30 years of age, 1.68% in patients between 31 and 40, 2.67% in patients between 41 and 50, and 5.12% in patients older than 50 (p < 0.001). Older patients also had a higher rate of deep surgical site infections and blood transfusions (p ≤ 0.001). However, no differences were identified with multivariate analysis. While older patients had higher short-term complications following hip arthroscopy, age alone was not an independent predictor of adverse outcomes. Further investigation is necessary to determine the risk factors associated with significant postoperative morbidity in older patients undergoing hip arthroscopy.

Note

This study does not have any prior or duplicate submissions, or publications elsewhere of any part of the work including details of any presentation of the study as an abstract at a professional meeting.


 
  • References

  • 1 Sing DC, Feeley BT, Tay B, Vail TP, Zhang AL. Age-related trends in hip arthroscopy: a large cross-sectional analysis. Arthroscopy 2015; 31 (12) 2307-13.e2
  • 2 Colvin AC, Harrast J, Harner C. Trends in hip arthroscopy. J Bone Joint Surg Am 2012; 94 (04) e23
  • 3 Degen RM, Bernard JA, Pan TJ. , et al. Hip arthroscopy utilization and associated complications: a population-based analysis. J Hip Preserv Surg 2017; 4 (03) 240-249
  • 4 Bozic KJ, Chan V, Valone III FH, Feeley BT, Vail TP. Trends in hip arthroscopy utilization in the United States. J Arthroplasty 2013; 28 (8, Suppl): 140-143
  • 5 Stevens MS, Legay DA, Glazebrook MA, Amirault D. The evidence for hip arthroscopy: grading the current indications. Arthroscopy 2010; 26 (10) 1370-1383
  • 6 Truntzer JN, Shapiro LM, Hoppe DJ, Abrams GD, Safran MR. Hip arthroscopy in the United States: an update following coding changes in 2011. J Hip Preserv Surg 2017; 4 (03) 250-257
  • 7 Minkara AA, Westermann RW, Rosneck J, Lynch TS. Systematic review and meta-analysis of outcomes after hip arthroscopy in femoroacetabular impingement. Am J Sports Med 2018; •••: 363546517749475
  • 8 Menge TJ, Briggs KK, Dornan GJ, McNamara SC, Philippon MJ. Survivorship and outcomes 10 years following hip arthroscopy for femoroacetabular impingement: labral debridement compared with labral repair. J Bone Joint Surg Am 2017; 99 (12) 997-1004
  • 9 Matsuda DK, Carlisle JC, Arthurs SC, Wierks CH, Philippon MJ. Comparative systematic review of the open dislocation, mini-open, and arthroscopic surgeries for femoroacetabular impingement. Arthroscopy 2011; 27 (02) 252-269
  • 10 Philippon M, Schenker M, Briggs K, Kuppersmith D. Femoroacetabular impingement in 45 professional athletes: associated pathologies and return to sport following arthroscopic decompression. Knee Surg Sports Traumatol Arthrosc 2007; 15 (07) 908-914
  • 11 O'Connor M, Minkara AA, Westermann RW, Rosneck J, Lynch TS. Return to play after hip arthroscopy: a systematic review and meta-analysis. Am J Sports Med 2018; •••: 363546518759731
  • 12 Schüttler KF, Schramm R, El-Zayat BF, Schofer MD, Efe T, Heyse TJ. The effect of surgeon's learning curve: complications and outcome after hip arthroscopy. Arch Orthop Trauma Surg 2018
  • 13 Harris JD, McCormick FM, Abrams GD. , et al. Complications and reoperations during and after hip arthroscopy: a systematic review of 92 studies and more than 6,000 patients. Arthroscopy 2013; 29 (03) 589-595
  • 14 Anthony CA, Pugely AJ, Gao Y. , et al. Complications and risk factors for morbidity in elective hip arthroscopy: a review of 1325 cases. Am J Orthop 2017; 46 (01) E1-E9
  • 15 Yu SW, Szulc AL, Walton SL, Davidovitch RI, Bosco JA, Iorio R. Liposomal bupivacaine as an adjunct to postoperative pain control in total hip arthroplasty. J Arthroplasty 2016; 31 (07) 1510-1515
  • 16 Basques BA, Gardner EC, Varthi AG. , et al. Risk factors for short-term adverse events and readmission after arthroscopic meniscectomy: does age matter?. Am J Sports Med 2015; 43 (01) 169-175
  • 17 Schairer WW, Nwachukwu BU, Fu MC, Warren RF. Risk factors for short-term complications after rotator cuff repair in the United States. Arthroscopy 2018; 34 (04) 1158-1163
  • 18 Domb BG, Linder D, Finley Z. , et al. Outcomes of hip arthroscopy in patients aged 50 years or older compared with a matched-pair control of patients aged 30 years or younger. Arthroscopy 2015; 31 (02) 231-238
  • 19 Javed A, O'Donnell JM. Arthroscopic femoral osteochondroplasty for cam femoroacetabular impingement in patients over 60 years of age. J Bone Joint Surg Br 2011; 93 (03) 326-331
  • 20 Philippon MJ, Schroder E Souza BG, Briggs KK. Hip arthroscopy for femoroacetabular impingement in patients aged 50 years or older. Arthroscopy 2012; 28 (01) 59-65
  • 21 ACS NSQIP Participant Use Data File. American College of Surgeons. Available at: https://www.facs.org/quality-programs/acs-nsqip/participant-use . Accessed June 1, 2018
  • 22 Trickey AW, Wright JM, Donovan J. , et al. Interrater reliability of hospital readmission evaluations for surgical patients. Am J Med Qual 2017; 32 (02) 201-207
  • 23 Boddapati V, Fu MC, Schairer WW. , et al. Increased shoulder arthroscopy time is associated with overnight hospital stay and surgical site infection. Arthroscopy 2018; 34 (02) 363-368
  • 24 Boddapati V, Fu MC, Schairer WW, Gulotta LV, Dines DM, Dines JS. Revision total shoulder arthroplasty is associated with increased thirty-day postoperative complications and wound infections relative to primary total shoulder arthroplasty. HSS J 2018; 14 (01) 23-28
  • 25 Boddapati V, Fu MC, Mayman DJ, Su EP, Sculco PK, McLawhorn AS. Revision total knee arthroplasty for periprosthetic joint infection is associated with increased postoperative morbidity and mortality relative to noninfectious revisions. J Arthroplasty 2018; 33 (02) 521-526
  • 26 Byrd JW. Hip arthroscopy: surgical indications. Arthroscopy 2006; 22 (12) 1260-1262
  • 27 Gwathmey FW. Advances in hip arthroscopy. Clin Sports Med 2016; 35 (03) xv-xvi
  • 28 Menge TJ, Briggs KK, Philippon MJ. Predictors of length of career after hip arthroscopy for femoroacetabular impingement in professional hockey players. Am J Sports Med 2016; 44 (09) 2286-2291
  • 29 Lynch TS, Terry MA, Bedi A, Kelly BT. Hip arthroscopic surgery: patient evaluation, current indications, and outcomes. Am J Sports Med 2013; 41 (05) 1174-1189
  • 30 Domb BG, Gui C, Lodhia P. How much arthritis is too much for hip arthroscopy: a systematic review. Arthroscopy 2015; 31 (03) 520-529
  • 31 Frank RM, Lee S, Bush-Joseph CA, Salata MJ, Mather III RC, Nho SJ. Outcomes for hip arthroscopy according to sex and age: a comparative matched-group analysis. J Bone Joint Surg Am 2016; 98 (10) 797-804
  • 32 Martin CT, Pugely AJ, Gao Y, Wolf BR. Risk factors for thirty-day morbidity and mortality following knee arthroscopy: a review of 12,271 patients from the national surgical quality improvement program database. J Bone Joint Surg Am 2013; 95 (14) e98 , 1–10