Arthroscopy - 2026-04-17 - Journal Article
Type 1 Diabetes Mellitus Correlates With Increased Postoperative Complications and Rates of Conversion to Total Hip Arthroplasty Following Hip Arthroscopy for Femoroacetabular Impingement Syndrome.
Girardi KG, Surucu S, Jonnalagadda A, Jayaram RH, Choksi S, Ansah-Twum JK, Gillinov SM, Grauer JN, Jimenez AE
Topics
Key Takeaway
T1DM confers a 5.81-fold increased odds of any 90-day adverse event and a 9.4% vs 6.4% 5-year THA conversion rate following hip arthroscopy for FAI syndrome.
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Summary
This study used the PearlDiver M170 database (2010–2023) to determine whether T1DM independently predicts worse outcomes after hip arthroscopy for FAI/labral tears, matching T1DM patients 1:4 by age, sex, and Elixhauser comorbidity index. T1DM patients had significantly higher 90-day odds of any adverse event (OR=5.81), severe adverse events (OR=2.65), minor adverse events (OR=5.63), and ED visits (OR=4.03), all p<0.0001. Five-year THA conversion was also higher in the T1DM cohort (9.4% vs 6.4%, p=0.05).
Key Limitation
The 5-year THA conversion p-value of 0.05 is marginal, and the database cannot distinguish whether conversions reflect arthroscopy failure versus natural disease progression independent of the index procedure.
Original Abstract
PURPOSE
To leverage a large national database to assess the association of type 1 diabetes mellitus (T1DM) with hip arthroscopy outcomes in patients with labral tears and/or femoroacetabular impingement syndrome.
METHODS
Patients who underwent hip arthroscopy for labral tears and/or femoroacetabular impingement syndrome were abstracted from the 2010 to 2023 PearlDiver M170 database. Patients with T1DM were matched 1:4 with those without T1DM based on age, sex, and Elixhauser comorbidity index. Multivariable logistic regression was used to assess the relationship between T1DM and 90-day postoperative adverse events as well as emergency department visits. Five-year conversion rates to total hip arthroplasty were assessed and compared with a log-rank test.
RESULTS
Of 69,679 patients undergoing hip arthroscopy, T1DM was identified in 951 patients (1.4%). After matching, 760 patients undergoing hip arthroscopy with T1DM were matched with 2968 patients without T1DM. Those with T1DM had significantly higher 90-day odds of any adverse events (odds ratio [OR] = 5.81), severe adverse events (OR = 2.65), minor adverse events (OR = 5.63), and emergency department visits (OR = 4.03) (P < .0001 for all). Five-year conversion to total hip arthroplasty was statistically significantly higher in the T1DM group (9.4% vs 6.4%, P = .05).
CONCLUSIONS
Patients with T1DM undergoing hip arthroscopy for labral tears and/or femoroacetabular impingement syndrome showed significantly higher rates of postoperative adverse events and emergency department visits, as well as greater rates of 5-year conversion to total hip arthroplasty compared with a matched control group without T1DM.
LEVEL OF EVIDENCE
Level III, retrospective comparative case-control study.