Increasing Rates of Capsular Repair in Pediatric Hip Arthroscopy: A Trend Analysis between 2014 and 2022

There has been a substantial rise in the performance of hip arthroscopy procedures in pediatric patients. However, with regards to procedural technique or patient-surgeon demographics, the utilization of hip arthroscopy remains less understood. This study aimed to determine whether the incidence of pediatric hip arthroscopy is continuing to increase and if surgical techniques have changed over time.

All pediatric patients who underwent hip arthroscopy between 2014 and 2022 were retrospectively reviewed from a multi-institutional database within a single health-system. Pearson correlation was utilized to determine trend significance while a two-sample Z test was performed to compare proportions. As no cases were performed in 2014, proportion trends were calculated from 2015 onward.

Seventy-three hip arthroscopies performed on 64 patients (9 staged bilateral) were evaluated. Between 2015 and 2022, there was a 266.67% increase in the annual number of pediatric hip arthroscopy procedures performed and a 400% increase in the number of surgeons performing hip arthroscopy annually. Femoroacetabular impingement (FAI)-related pathology accounted for 90.4% of all indications. Furthermore, the proportion of cases performed for isolated FAI increased over time (R=0.72, P=0.03). Cases were increasingly performed as outpatient procedures (R=0.72, P=0.03). A growing percentage of cases included capsular closure (R=0.91, P=0.003). However, no significant trends were seen in labral management.

Over time, the number of procedures and the number of surgeons performing hip arthroscopy increased. A growing proportion of cases were performed by non-pediatric trained surgeons, in an outpatient setting, for isolated FAI and capsular closure.