Department of Orthopaedic Surgery, University of California-San Francisco, San Francisco, California, U.S.A.
Department of Orthopaedic Surgery, University of California-San Francisco, San Francisco, California, U.S.A..
Arthroscopy. 2021 Dec;37(12):3445-3454.e1. doi: 10.1016/j.arthro.2021.04.017. Epub 2021 Apr 24.
PURPOSE: To report contemporary trends in hip arthroscopy case volume in the United States using a large cross-sectional cohort with accurate laterality tracking for assessment of revision surgery and rates of conversion to total hip arthroplasty (THA). METHODS: Using Current Procedural Terminology codes, we queried the Mariner PearlDiver dataset for patients who underwent hip arthroscopy from 2010 to 2017. Patient demographics were recorded and subsequent hip arthroscopy procedures and THA conversion within 2 years after surgery were tracked using International Classification of Diseases, Tenth Revision codes to accurately identify laterality. Emergency department and hospital admission within 30 days after surgery were queried. RESULTS: Of the 53,103 patients undergoing hip arthroscopy procedures, hip arthroscopy case volume increased 2-fold from 2010 to 2014 but remained relatively unchanged from 2014 to 2017. The most common age group undergoing surgery was 40 to 49 years, and female patients represented 70% of cases. Two-year subsequent surgery rate was 19%, with 15.1% undergoing a revision arthroscopy and 3.9% converting to THA. The most common revision arthroscopy procedures were femoroplasty (9.5%), labral repair (8.5%), and acetabuloplasty (4.3%). Younger patients were more likely to undergo revision arthroscopy (18% age 10-19 years; 15% age 20-29 years). Older patients had a significant risk for conversion to THA within 2 years (36% age 60-69 years; 28% age 50-59 years). Female patients also demonstrated a slightly greater rate of conversion to THA (4.1% female, 3.5% male, P <.0001). Patients 20 to 29 years had the greatest risk of emergency department admission (5.4%) and hospital admission (0.8%) within 30 days of surgery. CONCLUSIONS: The rise in hip arthroscopy procedures may be starting to plateau in the United States. Cross-sectional data also indicate that there is a greater than previously reported rate of revision hip arthroscopy in patients younger than 30 years of age and conversion to THA in patients older than 50 years of age. LEVEL OF EVIDENCE: III, cross-sectional study.
目的：利用一项大型横断面队列研究，报告美国髋关节镜手术的当代趋势，该队列对手术侧别进行了准确跟踪，以评估翻修手术和全髋关节置换术（THA）的转化率。
方法：使用当前程序术语（Current Procedural Terminology，CPT）代码，我们对 Mariner PearlDiver 数据集进行了查询，以获取 2010 年至 2017 年期间接受髋关节镜手术的患者。记录患者人口统计学资料，并使用国际疾病分类第十次修订版（International Classification of Diseases，Tenth Revision，ICD-10）代码对后续髋关节镜手术和术后 2 年内的 THA 转换进行跟踪，以准确识别手术侧别。还对术后 30 天内的急诊和住院情况进行了查询。
结果：在接受髋关节镜手术的 53103 名患者中，髋关节镜手术量从 2010 年到 2014 年增加了两倍，但从 2014 年到 2017 年基本保持不变。手术患者中最常见的年龄组为 40 岁至 49 岁，女性患者占 70%。2 年后续手术率为 19%，其中 15.1%行翻修关节镜手术，3.9%行 THA 转换。最常见的翻修关节镜手术包括股骨成形术（9.5%）、盂唇修复术（8.5%）和髋臼成形术（4.3%）。年轻患者更有可能行翻修关节镜手术（18%的 10-19 岁患者；15%的 20-29 岁患者）。年龄较大的患者在 2 年内行 THA 转换的风险显著增加（60-69 岁年龄组 36%；50-59 岁年龄组 28%）。女性患者行 THA 转换的比例也略高（女性 4.1%，男性 3.5%，P<0.0001）。20-29 岁患者术后 30 天内急诊（5.4%）和住院（0.8%）的风险最高。
结论：美国髋关节镜手术的数量可能开始趋于平稳。横断面数据还表明，在 30 岁以下患者中，髋关节镜翻修的比例高于之前报道，在 50 岁以上患者中，THA 转换的比例也高于之前报道。
证据等级：III 级，横断面研究。
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