Losartan Is Not Associated With Decreased Postoperative Arthrofibrosis After Hip Arthroscopy
Arthroscopy The Journal of Arthroscopic and Related Surgery · 24 Aug 2026
† Impact is the editorial-priority score. All scores are out of 100. Clinical is a stored clinical-importance score from the earlier method; it has not been recalculated.
Why it matters
Losartan has been promoted as a low-cost adjunct to reduce postoperative stiffness after hip arthroscopy, so a large database study finding no measurable benefit is relevant to whether surgeons should continue prescribing it for this indication.
The evidence
This retrospective database study used the TriNetX network to compare hip arthroscopy patients prescribed losartan (n=947 after matching) with a matched cohort not given ACE inhibitors or ARBs, looking at rates of capsulolabral adhesions, hip instability, conversion to THA, osteoarthritis, and medical complications up to 2 years. Lysis of adhesions and ankylosis rates were too low to even generate reportable patient counts in either group, and no orthopaedic or medical complication differed significantly between losartan and non-losartan patients at any time point, including in subgroups by sex or age under 30.
A coherent primary effect estimate is unavailable. Clinical relevance does not estimate treatment benefit.
Why this rigour score?
Retrospective cohortDesign starting point: 29.6
Raised the score
- Post-adjustment balance demonstrated+4.3
- Compared against current standard of care+3.4
Lowered the score
- Exposure defined after cohort entry (immortal time bias)−11.9
- Only 1 months of follow-up−9.8
Methods at a glance
Recorded assessment- Confounding adjustmentPropensity scores
- Covariate balance confirmedMet
- Outcome assessors blindedNot reported
- Comparable start of follow-upNot met
- Adequate statistical powerNot reported
- Prospective registrationNot met
Not reported does not mean not done. Checks have different weights; this is not a count of boxes ticked.
See the full score breakdown
- Study design starting point
- 29.6
- Post-adjustment balance demonstrated
- +4.3
- Exposure defined after cohort entry (immortal time bias)
- −11.9
- Compared against current standard of care
- +3.4
- Only 1 months of follow-up
- −9.8
- Journal prior (not an observed method)
- +0.8
- Final rigour score rounded
- 16 / 100
Study design sets the starting point and a ceiling of 72. Recorded methods then adjust the score. Points are shown to one decimal place; the final score uses unrounded values.
Checklist from the stored appraisal. “Not met” describes the recorded criterion; it does not always produce a deduction. This overview supports reading the full study.
For journal club
1.If arthroscopic lysis of adhesions occurred too rarely in this database to even be counted, should surgeons continue prescribing losartan empirically, or wait for a study powered to detect a real difference?
2.Given that osteoarthritis rates were transiently higher in the losartan group at 30 days but not later, how should surgeons interpret early postoperative radiographic or symptomatic findings in patients on antifibrotic agents?
Original publication title
Losartan Is Not Associated With Decreased Postoperative Arthrofibrosis After Hip Arthroscopy