Summary

Diabetic patients undergoing hip arthroscopy had significant improvements in patient-reported outcomes and comparable outcomes to non-diabetic patients.

Abstract

Purpose

The purpose of this study is to report outcomes of patients undergoing hip arthroscopy with diabetes mellitus (DM) and to compare their outcomes to a control group of non-diabetic (non-DM) patients, with a sub-analysis based on glycemic control.

Methods

Data was prospectively collected and retrospectively analyzed data for patients who underwent hip between February 2008 and April of 2022 with a history of DM. Included patients had completed minimum 2-years follow-up. Patients were propensity matched to a control group of non-DM in a 1:3 ratio based on sex, age at surgery, BMI, follow-up time, Acetabular Outerbridge Grade, labral treatment, and capsular treatment. A sub-analysis stratified patients by DM control, depending on pre-prandial glucose or HbA1c. Clinically important thresholds for hip arthroscopy, revision surgery and conversion to arthroplasty rates were compared.

Results

A total of 116 patients were included in the study. DM patients displayed significant improvements across all PROs. When compared to the non-DM group, DM patients had lower preoperative scores, but similar magnitudes of improvement and postoperative scores for mHHS, NAHS, HOS-SSS and VAS. The groups reached clinically important thresholds at similar rates. Patients in the DM group had a higher frequency of revision hip arthroscopy with 24.1% of DM patients compared to 9.2% patients in the non-DM group, resulting in a calculated relative risk of 2.63 (p < 0.05). There were no significant differences in outcomes with respect to glycemic control.

Conclusion

DM patients undergoing hip arthroscopy had significant improvements in PROs and comparable outcomes to non-DM patients. DM patients had a 2.63-fold increased relative risk of revision hip arthroscopy compared to non-DM patients, with a trend suggesting that uncontrolled blood sugar can more often lead to revision hip arthroscopy. Perioperative diabetic control is recommended.