Paper 09: Revision rate following primary hip arthroscopy in patients given prophylactic oral losartan for the prevention of post-surgical fibrosis versus no losartan

Abstract

Objectives: To evaluate whether postoperative treatment with Losartan decreased the revision rate in patients undergoing primary hip arthroscopy. Methods: Patients underwent primary hip arthroscopy with labral repair and CAM osteoplasty and rim trimming between 2012 and 2017. Patients who underwent microfracture, labral debridement or reconstruction, core decompression, ligamentous teres repair or reconstruction, or capsular reconstruction were excluded. Losartan was added to all patients’ post-operative protocol in December 2015. Patients who underwent hip arthroscopy prior to November 2015 were included in the no-Losartan group (NOLOS) and patients who had arthroscopy between December 2015 and Dec 2017 were included in the losartan group (LOS). Results: Of the 964 cases, follow-up was obtained on 673 patients (70%). There were 405 patients in the NOLOS group and 268 in the LOS group. There was no difference in gender distribution (P=0.128) between groups. The LOS group was significantly older (36.6 ±13 years) compared to the NOLOS group (34.1±11)(p=0.012). Average follow-up in the NOLOS group was 5.8±2 years and was 4.1±1 years in the LOS group. Revision hip arthroscopy was required in 35 (8.6%) patients in the NOLOS group and 6 (2.2%) patients in the LOS group(p=0.001). There was no difference in age between those patients who required revision (32±11 years) and those who did not(35±12 years)(p=0.137). Conclusions: The prevalence of revision hip arthroscopy was significantly lower (2.2%) in patients who took Losartan as part of their post-operative protocol compared to those who did not (8.6%). Reduction in the need for revision hip arthroscopy can improve patient outcomes and reduce healthcare dollars spent.