Purpose
To analyze a large national private payer population in the United States for trends
over time in hip arthroscopy by age groups and to determine the rate of conversion
to total hip arthroplasty (THA) after hip arthroscopy.
Methods
We performed a retrospective analysis using the PearlDiver private insurance patient
record database from 2007 through 2011. Hip arthroscopy procedures including newly
introduced codes such as osteochondroplasty of cam and pincer lesions and labral repair
were queried. Hip arthroscopy incidence and conversion rates to THA were stratified
by age. Chi-squared analysis was used for statistical comparison. Conversion to THA
was evaluated using Kaplan-Meier analysis.
Results
From 2007 through 2011, 20,484,172 orthopaedic patients were analyzed. Hip arthroscopy
was performed in 8,227 cases (mean annual incidence, 2.7 cases per 10,000 orthopaedic
patients). The incidence of hip arthroscopies increased over 250% from 1.6 cases per
10,000 in 2007 to 4.0 cases per 10,000 in 2011 (P < .0001). Patients in the 40 to 49 age group made up 28% of cases, followed by patients
ages 30 to 39 (22%) and 50 to 59 (19%). Patients under 30 years old showed the greatest
increase in incidence from 2007 to 2011 (335%), but patients over 60 still had over
a 200% increase. Labral debridement was the most common procedure (6,031 cases), and
approximately 1.6 procedural codes were billed for every case performed. Labral repair
was more common in patients under 30, while labral debridement was more common in
older age groups (P = .046). Within 24 months of hip arthroscopy, 17% of patients older than 50 required
conversion to THA, compared with <1% of patients under 30 (P < .0001).
Conclusions
Hip arthroscopy procedures are increasing in popularity across all age groups, with
patients ages 40 to 49 having the highest incidence in this large cross-sectional
population, despite a high rate of early conversion to THA within 2 years in patients
over 50.
Level of Evidence
IV, cross-sectional study.
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Article info
Publication history
Published online: July 17, 2015
Accepted:
June 5,
2015
Received:
December 6,
2014
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article.
Identification
Copyright
© 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
