Trends in Hip Arthroscopy Utilization in the United States

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Abstract

Introduction

The purpose of this study was to evaluate the changing incidence of hip arthroscopy procedures among newly trained surgeons in the United States, the indications for hip arthroscopy, and the reported rate of post-operative complications.

Methods

The ABOS database was used to evaluate the annual incidence of hip arthroscopy procedures between 2006–2010. Procedures were categorized by indication and type of procedure. The rate of surgical complications was calculated and compared between the published literature and hip arthroscopy procedures performed for femoroacetabular impingement (FAI)/osteoarthritis (OA) and for labral tears among the newly trained surgeon cohort taking the ABOS Part II Board exam.

Results

The overall incidence of hip arthroscopy procedures performed by ABOS Part II examinees increased by over 600% during the 5-year period under study from approximately 83 in 2006 to 636 in 2010. The incidence of hip arthroscopy for FAI/OA increased steadily over the time period under study, while the incidence of hip arthroscopy for labral tears was variable over time. The rate of surgical complications was 5.9% for hip arthroscopy procedures for a diagnosis of FAI/OA vs. 4.4% for a diagnosis of labral tear (P = 0.36).

Conclusions

The incidence of hip arthroscopy has increased dramatically over the past 5 years, particularly for the indication of FAI/OA. Reported surgical complication rates are relatively low, but appear higher than those rates reported in previously published series. Appropriate indications for hip arthroscopy remain unclear.

Section snippets

Methods

The American Board of Orthopaedic Surgery (ABOS) database was used to evaluate the annual incidence of hip arthroscopy procedures among ABOS Part II examinees for calendar years 2006–2010. There are 2 parts to the certification process by the ABOS, Part I, a written examination taken on completion of an accredited orthopedic residency program, and Part II, an oral examination after practicing for at least twenty-two months. ABOS certification candidates record and submit consecutive surgical

Results

The overall incidence of hip arthroscopy procedures performed by ABOS Part II examinees increased by over 600% during the 5-year period under study, from 83 procedures in 2006 to 636 procedures in 2010 (Fig. 1). The general characteristics of patients are described in Table 3. The most common procedure was hip arthroscopy with debridement, chondroplasty, and/or resection of the labrum. The incidence of hip arthroscopy for FAI/OA increased steadily over the time period under study (from 32

Discussion

The incidence of hip arthroscopy has increased dramatically over the past 5 years, particularly for the indication of FAI/OA. The reasons for this are unclear, but may include increased exposure to hip arthroscopy during residency training; increased recognition of and diagnosis of early adult hip disease; and enthusiasm among surgeons and patients for newer, less invasive treatments for the management of hip disease. There have been many observational studies that have shown improved outcomes,

Acknowledgments

The authors wish to thank the American Board of Orthopaedic Surgery (ABOS) for their assistance in providing data for our study.

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The Conflict of Interest statement associated with this article can be found at http://dx.doi.org/10.1016/j.arth.2013.02.039.

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