Surgical Trends in Arthroscopic Hip Surgery using a Large National Database
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1 Surgical Trends in Arthroscopic Hip Surgery using a Large National Database Nicholas A. Bonazza, M.D. 1, Guodong Liu, Ph.D. 2, Douglas Leslie, Ph.D. 2, Aman Dhawan, M.D. 1 1 Department of Orthopaedics and Rehabilitation, Penn State Health, Milton S. Hershey Medical Center 2 Penn State College of Medicine, Hershey, Pennsylvania
2 Background Hip arthroscopy has seen dramatic growth over the past several years. 1,2,3 As technology improves, indications continue to evolve. Purpose: Assess the practice trends in hip arthroscopy over a more recent time period, without concerns for Hawthorne or Observer effect as can be seen during a boards collection window, and in a larger volume of patients with a more comprehensive database than previous published data. Hypothesis: number of hip arthroscopies done each year is increasing and that labral repairs, femoroplasty and acetabuloplasty are increasing compared to labral debridements alone.
3 Methods The MarketScan Commercial Claims and Encounters Database was searched using ICD-9 and CPT codes to identify patients who underwent any arthroscopic hip procedure from including soft tissue procedures such as labral debridement or labral repair as well as osseous procedures such as femoroplasty or acetabuloplasty. The MarketScan Commercial Claims and Encounters Database is a medical and drug insurance claims database which contains inpatient and outpatient records and services. It consists of data from over 100 insurance companies and large employers and contained information for over 39 million individual patients for each year included in our study. Patients identified were characterized by gender, age group and year of the initial procedure. Data for procedures was also divided between index procedures and revision procedures. Regression analysis was used to evaluate differences in surgical trends between individual patient groups delineated by age and gender. The Cochran- Armitage trend test was used to identify significant differences in surgical trends seen yearly.
4 Results 27,997 patients, 62,782 procedures Incidence increased each year of study Total Number of Hip Arthroscopy Cases Case Distribution By Year Year
5 Results Number of Cases Case Distribution by Gender Procedure Male Females - Denotes Statistical Significance Females more likely to undergo any procedure (p <.0001)
6 Results Case Distribution By Age Labral debridement most common procedure across entire study period for all age groups Percentage of All Hip Arthroscopy Cases 30% 25% 20% 15% 10% 5% 0% Under Age Group
7 Results Percentage of Patients Undergoing Revision Arthroscopic Procedure Rate of Revision by Primary Procedure Type 2,754 patients (10%) 11.00% 10.50% 10.00% 9.50% 9.00% 8.50% underwent at least one revision procedure No significant difference by index No gender more likely to undergo revision arthroscopy Primary Procedure Type
8 Conclusions Arthroscopic hip procedures continue to increase in incidence Females are more likely to undergo any procedure (p <.0001) Femoroplasty has become the most common procedure performed Patients age underwent the most arthroscopic hip procedures. Labral/chondral debridement most common revision procedure No index procedure is statistically more likely to result in a revision Gender not a factor for revision arthroscopy but males slightly more likely to undergo THA soon after arthroscopy (6.3% versus 5.5%, p =.006) 6% of patients undergo hip arthroplasty within 5 years of having hip arthroscopy Patients undergoing loose body removal most likely to undergo THA during study
9 References 1. Bozic KJ, Chan V, Valone FH, 3rd, Feeley BT, Vail TP. Trends in hip arthroscopy utilization in the United States. J Arthroplasty. 2013;28(8 Suppl): PMID: Colvin AC, Harrast J, Harner C. Trends in hip arthroscopy. The Journal of bone and joint surgery American volume. 2012;94(4):e23. PMID: Montgomery SR, Ngo SS, Hobson T, Nguyen S, Alluri R, Wang JC, Hame SL. Trends and demographics in hip arthroscopy in the United States. Arthroscopy. 2013;29(4): PMID:
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The Cryo/Cuff provides two functions: 1. Compression - to keep swelling down. 2. Ice Therapy - to keep swelling down and to help minimize pain. Patien
The Cryo/Cuff provides two functions: 1. Compression - to keep swelling down. 2. Ice Therapy - to keep swelling down and to help minimize pain. Patients, for the most part, experience less pain and/or
Hip arthroscopy. Anatomy The hip is functionally a ball and socket joint.
Hip arthroscopy The term arthroscopy (or keyhole surgery) refers to the viewing of the inside of a joint through a small operating telescope. First described in the 1970s, arthroscopic techniques have
The Influence of Patient Activation, Pain Self-Efficacy, and Resilience on Patient-Reported Pain and Function in Patients with Hip and Knee Arthritis
The Influence of Patient Activation, Pain Self-Efficacy, and Resilience on Patient-Reported Pain and Function in Patients with Hip and Knee Arthritis Tiffany C. Liu BA, Tom Crijns BSc, Kevin J. Bozic MD
Hip Cases from Clinic: Refining your history and physical
Hip Cases from Clinic: Refining your history and physical Alan Zhang MD Assistant Professor Sports Medicine and Hip Arthroscopy UCSF Department of Orthopaedic Surgery 11/20/2017 Case #1 Healthy 21 M College
Diagnoses and Health Care Utilization of Children Who Are in Foster Care and Covered by Medicaid
Behavioral Health is Essential To Health Prevention Works Treatment is Effective People Recover Diagnoses and Health Care Utilization of Children Who Are in Foster Care and Covered by Medicaid Diagnoses