Purpose:

To determine incidence and risk factors for symptomatic venous thromboembolism following hip arthroscopy (HA) and thromboprophylaxis prescription utilization for these procedures.

Methods:

The PearlDiver Mariner Database was queried using Current Procedural Terminology (CPT) codes to identify adult patients (≥18 years old) who underwent HA between 2010 to 2020. Patient demographic information, including age, oral contraceptive use, medical comorbidities, and perioperative thromboprophylaxis utilization was recorded using International Classification of Disease (ICD) and National Drug Codes (NDCs). Incidence of postoperative venous thromboembolism (VTE) within 90 days was determined. Multivariate logistic regression was used to identify predictors of perioperative thromboprophylaxis utilization and VTE risk factors.

Results:

Queried records found that 60,181 patients met inclusion criteria and 367 patients (0.6%) experienced VTE, including DVT (0.5%) and/or PE (0.2%). Approximately 2.1% of patients utilized thromboprophylaxis, including aspirin (1.1%), low-molecular-weight heparin (LMWH) (0.9%) and oral factor Xa inhibitors (0.1%). Oral contraceptive pill use (adjusted odds ratio [aOR]=2.16, 95% confidence interval [CI]=1.34-3.46), obesity (aOR=1.37, 95% CI = 1.05-1.79), and a history of malignancy (aOR=1.69, 95% CI = 1.12-2.54) were associated with increased odds of experiencing VTE. Perioperative thromboprophylaxis (aOR=0.52, 95% CI=0.19-1.39) was not significantly associated with decreased odds of experiencing VTE. However, obesity (aOR=1.17, 95% CI=1.00-1.38) and hypertension (aOR=1.17, 95% CI=1.02-1.36) were associated with increased odds of thromboprophylaxis prescription utilization.

Conclusions:

While the overall risk of symptomatic VTE following HA remains low, oral contraceptive use, obesity, and a history of malignancy are associated with increased odds of thrombotic event within 90 days. Routine thromboprophylaxis after hip arthroscopy may not be indicated for all patients but can be considered based on patient-specific risk factors.

Level of evidence:

Level III, Retrospective Prognostic Comparative Trial.