A Shift in Hip Arthroscopy Use by Patient Age and Surgeon Volume: A New York State–Based Population Analysis 2004 to 2016


      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.


      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.


      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.


      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

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      Linked Article

      • Editorial Commentary: Hip Arthroscopy—Bimodal Bump and Volume Matters
        ArthroscopyVol. 35Issue 10
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          In the experience of a high-volume hip arthroscopic surgeon with a referral practice, a bimodal age distribution could be common. Younger patients presenting with symptomatic hip pathology recalcitrant to nonoperative management may seek or be referred to high-volume surgeons, and older patients absent significant osteoarthritis may also be surgical candidates. Lower-volume hip surgeons could have higher complication rates, and it is incumbent on higher-volume surgeons to train upcoming colleagues as hip arthroscopy continues to grow.
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