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Article Dans Une Revue Orthopaedics & Traumatology: Surgery & Research Année : 2020

Hip arthroscopy in France: an epidemiological study of postoperative care and outcomes involving 3,699 patients.

Résumé

Background Hip arthroscopy is a surgical procedure that is becoming more and more prevalent in France. Even though indications are now well-established little is still known about patient outcomes. Therefore, the purpose of our retrospective study was to: (1) describe the circumstances in which hip arthroscopies are being performed; (2) study arthroscopy and arthroplasty reoperation rates; (3) assess the incidence of readmissions for complications. Hypothesis Hip arthroscopy in France produced similar results to those observed in other countries. Materials and methods We conducted a cohort study from January 2008 to December 2014 in the French population using the national hospital discharge database called “Programme de médicalisation des systèmes d’information (PMSI).” We included all admissions that had a hip arthroscopy code and analyzed readmissions for conversion to hip arthroplasty, revision hip arthroscopy and complications (without being able to provide detailed descriptions). Risk factors associated with conversion, revision and readmission for complications were studied after performing a population analysis. Results A total of 3,699 patients were included over a period of seven years. The mean age was 40 years, with women being significantly older (mean age of 43 years) than men (38 years) (p < 0.05). The number of procedures increased from 240 in 2008 to 702 in 2014. Synovectomies (67.9%; 2514/3699) and surgical bone procedures (acetabuloplasty or femoroplasty) (47.3%; 1751/3699) were the main procedures performed during the primary arthroscopy. In total, 410 patients underwent a conversion to arthroplasty, 231 patients had a revision arthroscopy, and 126 patients suffered a complication. Five years after the index procedure, the conversion rate was 16.3%, revision rate was 8.2%, and readmission rate for a postoperative complication was 5%. The main risk factor associated with conversions was [Hazard ratio (HR) and 95% Confidence Index (CI)] an age between 40 and 79 years during the first arthroscopy [3.04 (2.40; 3.87) compared with the reference class of 25–39 years]. Patients between ages 16 to 24 years during the first arthroscopy (0.35 [0.20; 0.61] compared with the reference class of 25–39 years) had a decreased risk of conversion (HR and 95% CI). The main risk factors associated with revisions were: synovectomies [1.90 (1.34; 2.70)] and surgical bone procedures on the femoral neck and/or the acetabulum [1.82 (1.36; 2.4)]. The risk factor associated with complication-related readmissions was an age greater than 40 years [2.23 (1.43; 3.49)]. Conclusion Unlike the international literature, our study population was largely male. The rates of revision (8.2% after five years) and conversion to arthroplasty (16.3% after five years) were relatively low and comparable to the different international studies. This procedure, which is not widely performed, is growing in popularity, has low morbidity and remains an interesting approach given the revision and conversion rates after five years. The implementation of specific coding for arthroscopic hip procedures and the pathologies to be treated seems warranted.

Dates et versions

hal-04111566 , version 1 (31-05-2023)

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Elio Disegni, Pierre Martinot, Julien Dartus, Henri Migaud, Sophie Putman, et al.. Hip arthroscopy in France: an epidemiological study of postoperative care and outcomes involving 3,699 patients.. Orthopaedics & Traumatology: Surgery & Research, 2020, Orthopaedics and Traumatology - Surgery and Research, 107 (1), pp.102767. ⟨10.1016/j.otsr.2020.102767⟩. ⟨hal-04111566⟩
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