Short To Midterm Outcomes Of Hip Arthroscopy In Patients With Diabetes Mellitus

Short To Midterm Outcomes Of Hip Arthroscopy In Patients With Diabetes Mellitus

Roger Quesada Jimenez, MD, UNITED STATES Drashti Sikligar, MEng, UNITED STATES Ady Haim Kahana Rojkind, MD, UNITED STATES Andrew R. Schab, BS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES

American Hip Institute Research Foundation, Des Plaines, Illinois, UNITED STATES


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Anatomic Location

Anatomic Structure

Treatment / Technique


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


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.