Losartan Is Not Associated With Decreased Postoperative Arthrofibrosis After Hip Arthroscopy

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 orthopedic or medical complication differed significantly between losartan and non-losartan patients at any time point, including in subgroups by sex or age under 30.

AI summary · from the full text · reviewed by Pukhraj Gaheer, Medical Student, Queen's University before publishing

Why it mattersLosartan 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.

Presenting this at rounds? Start here

• ?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?
• ?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?