A Shift in Hip Arthroscopy Use by Patient Age and Surgeon Volume: A New York State-Based Population Analysis 2004 to 2016.
Academic Article
Overview
abstract
PURPOSE: To perform a population-level analysis of the shifts in use of hip arthroscopy by different age groups and to describe the proportion of hip arthroscopy procedures performed by high-volume surgeons. METHODS: The Statewide Planning and Research Cooperative System database was combined with New York State census data to calculate changes in annual hip arthroscopy incidence by age and gender (2004-16). Annual (January to January) surgeon volumes were calculated and stratified into 4 thresholds that have been associated with significant differences in revision hip surgery rates to calculate changes in hip arthroscopy rates by surgeon volume over time. RESULTS: There was a 495% increase in hip arthroscopies from 2004 to 2016, from 2.35 to 15.47 per 100,000 residents in New York State. The largest increase was in the 10-19 years age group-a 2,150% increase for female patients (= 1.26, P < .001) and a 1,717% increase for male patients (incident rate ratio = 1.21, P < .001). The number of labral repairs performed with femoroplasty increased 52.8% (P < .001). The number of hip arthroscopy surgeons increased from 3.4 to 6.5 per 1 million residents. The number of hip arthroscopies performed by high-volume surgeons increased from 0% in 2004 to 24.7% in 2016. CONCLUSIONS: The use of hip arthroscopy has increased over the past 10 years, especially in the adolescent population ages 10-19. Over the same time period, there has been an emergence of high-volume hip arthroscopy surgeons and an increased proportion of procedures performed by these surgeons. Patients of high-volume surgeons tend to be younger, while lower volume surgeons tend to have older patients. LEVEL OF EVIDENCE: Level IV, case series.