Is Diabetes Mellitus a Negative Prognostic Factor for Patients Undergoing Hip Arthroscopy? A Matched-Controlled Study

Hypothesis: Patients with diabetes mellitus (DM) undergoing hip arthroscopy for labral tears have inferior outcomes at ≥2 years postoperatively compared to patients without DM.

Methods: Data were prospectively collected and retrospectively reviewed on patients that underwent hip arthroscopy between 2/2008 and 12/2014. Inclusion criteria were labral tears and preoperative modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score–Sports Specific Subscale (HOS-SSS), and Visual Analogue Scale (VAS). Exclusion criteria were preoperative Tönnis grade >1, previous hip conditions and/or ipsilateral hip surgery. After selecting eligible patients with minimum two-year follow-up, each patient was grouped based on whether DM was present at time of surgery. All patients with DM were matched (1:2 ratio) to control patients without DM. The matching criteria were age at surgery ±8 years, sex, BMI ±5, Worker’s Compensation claim, capsular treatment (release vs. plication), and acetabular Outerbridge grade 0 or 1 vs. 2-4.

Results: Of 29 eligible patients with DM, 26 (89.7%) had minimum two-year follow-up. Of 1,334 eligible patients without DM, 1,094 (82.0%) had minimum two-year follow-up. The matched comparisons included all 26 patients with DM and 52 randomly selected and unique control patients. Except for isolated femoroplasty being performed more frequently in the DM group (15.4% vs. 1.9%; p=0.04), no other statistically significant differences were detected in terms of demographics, preoperative radiographic imaging, intraoperative findings, procedures, preoperative scores, follow-up scores, revision rates, conversion rates to total hip arthroplasty (THA), or complication rates. Conversion to THA was exclusive to control patients.

Conclusions: Patients with DM demonstrate similar and favorable improvements at ≥2 years after arthroscopic labral treatment when compared to a matched control group without DM. No significant differences were observed when stratifying based on type 1 or type 2 DM.