Complication Rates for Hip Arthroscopy Are Underestimated: A Population-Based Study

• Published in: Arthroscopy Vol. 33; no. 6; pp. 1194 - 1201
• Main Authors: Truntzer, Jeremy N., M.D, Hoppe, Daniel J., M.D., M.Ed., F.R.C.S.C, Shapiro, Lauren M., M.D, Abrams, Geoffrey D., M.D, Safran, Marc, M.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2017
• Subjects: Adult; Aged; Arthroscopy - adverse effects; Databases, Factual; Female; Hip Dislocation - epidemiology; Hip Dislocation - etiology; Hip Joint - surgery; Humans; Insurance Claim Review; Male; Middle Aged; Orthopedics; Ossification, Heterotopic - epidemiology; Ossification, Heterotopic - etiology; Population Surveillance; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Postoperative Period; Retrospective Studies; United States - epidemiology; Venous Thrombosis - epidemiology; Venous Thrombosis - etiology
• ISSN: 0749-8063; 1526-3231
• DOI: 10.1016/j.arthro.2017.01.021

Purpose To identify major and minor complication rates associated with hip arthroscopy from a payer-based national database and compare with the rates reported in the existing literature. Methods Patients who underwent hip arthroscopy between 2007 and 2014 were identified using PearlDiver, a publicly available database. Rates of major and minor complications, as well as conversion to total hip arthroscopy (THA), were determined by using Current Procedural Terminology (CPT) and International Classification of Diseases, Ninth Revision (ICD-9), codes. Incidence rates of select major complications across the entire database were used as a comparison group. Statistical significance was set at P < .05. Results Of 18 million patients screened from 2007 to 2014, a total of 2,581 hip arthroscopies were identified. The rates of major and minor complications within a 1-year postoperative period were 1.74% and 4.22%, respectively. Complications included heterotopic ossification (2.85%), bursitis (1.23%), proximal femur fracture (1.08%), deep vein thrombosis (0.79%), and hip dislocation (0.58%). The rate of conversion to THA within 1 year was 2.85%. When compared to rates in the general population, the relative risks [RRs] of requiring a THA (age <50 years, RR = 57.66, P < .001; age >50 years, RR = 22.05, P < .001), sustaining a proximal femur fracture (age <50 years, RR = 18.02, P < .001; age >50 years, RR = 2.23, P < .001), or experiencing a hip dislocation (RR 19.60, P < .001) at 1 year after hip arthroscopy were significantly higher in all age groups. Conclusions Higher major complication rates after hip arthroscopy were observed using a national payer-based database than previously reported in the literature, especially in regard to hip dislocations and proximal femur fractures. Rates of total hip arthroplasty were similar to prior studies, whereas the rates of revision hip arthroscopy were higher. Level of Evidence Level IV, case series.