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A Shift in Hip Arthroscopy Use by Patient Age and Surgeon Volume: A New York State-Based Population Analysis 2004 to
William W Schairer1, Benedict U Nwachukwu2, Joash R Suryavanshi2
1Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, U.S.A..
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.
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