EP1.33 Short and Mid-Term Outcomes of Hip Arthroscopy for Femoroacetabular Impingement and Labral Tears in Patients with Diabetes

Background: Diabetes Mellitus (DM) has been recognized as an adverse prognostic factor in various surgical orthopedic interventions.

Purpose: To report outcomes of patients with DM who underwent hip arthroscopy for FAI and labral tears with a minimum 2-year follow-up with a sub-analysis based on glycemic control. Furthermore, to compare these results to a benchmark control group of non-DM patients.

Method: Retrospectively analyzed data for patients who underwent primary hip arthroscopy as treatment for FAI and labral tears between August of 2009 and January of 2022 with a personal history of DM. Included patients had complete pre- and postoperative patient reported outcomes (PROs) and visual analog scale (VAS) at minimum 2-years follow-up. A sub-analysis was conducted within the study group based on glycemic control. Patients were stratified into well-controlled DM if their pre-prandial glucose was ≤130 mg/dl or HbA1c was ≤7%. Clinical important thresholds for hip arthroscopy, revision surgery and conversion to arthroplasty rates were included in the analysis. Patients were propensity matched to a control group of non-diabetic patients in a 1:3 ratio based on sex, age at surgery, BMI, Acetabular Outerbridge Grade, labral treatment, and capsular treatment.

Results: 116 patients were included in the study. DM patients displayed significant improvements across all PROs and high patient satisfaction at 67.90 ± 44.71 months follow-up. No significant differences were observed in the sub-analysis. When compared to a benchmark control group, DM patients started with lower preoperative scores for modified Harris Hip Score (mHHS) and Nonarthritic Hip Score (NAHS). Furthermore, similar magnitudes of improvement were observed for mHHS, International Hip Outcome Tool-12 (iHOT-12), and VAS, with a significantly higher improvement for NAHS, reaching similar postoperative scores for all PROs. The groups reached clinically important thresholds at similar rates. DM patients had a higher frequency of revision hip arthroscopy with a relative risk of 2.63 (p < 0.05).

Conclusion: Hip arthroscopy for the treatment of FAI and labral tear in DM patients yielded significant short-term PROs improvements, which were equivalent to a benchmark matched control group of non-DM patients. However, DM patients had a 2.63-fold increased relative risk for revision hip arthroscopy.