Changing Surgeons for Revision Hip Arthroscopic Surgery Is Associated With Insurance Status, Geography, and Diagnosis of Anxiety or Depression.

BACKGROUND

Patients undergoing revision hip arthroscopic surgery may elect to undergo the procedure with their index surgeon or, in many instances, will change surgeons. Factors and outcomes associated with switching surgeons are likely multifactorial and require further study.

PURPOSE

To (1) examine clinical and demographic variables associated with switching surgeons between primary and revision hip arthroscopic surgery and (2) assess whether the rates of postoperative emergency department (ED) visits, complications, and conversion to total hip arthroplasty (THA) differed for patients who returned to the same surgeon versus those who switched surgeons.

STUDY DESIGN

Cross-sectional study; Level of evidence, 3.

METHODS

A national administrative claims database was used to identify patients with ICD (International Classification of Diseases)-10 diagnosis codes for femoroacetabular impingement and/or a labral tear who underwent primary hip arthroscopic surgery between 2015 and 2022, followed by ipsilateral revision hip arthroscopic surgery. National Provider Identifier numbers were used to track patients who returned to the same surgeon versus patients who switched surgeons for revision arthroscopic surgery. Factors associated with switching surgeons were identified. Rates of 30-day ED visits, 90-day adverse events, and 5-year conversion to THA after revision surgery were compared between groups.

RESULTS

Of 1332 revision hip arthroscopic procedures, 496 (37.2%) were performed by the index surgeon, and 836 (62.8%) were performed by a different surgeon. Age and sex were similar between groups; however, patients who switched surgeons were more likely to have commercial health insurance (90.7% vs 85.9%, respectively), be from the Midwest (40.7% vs 34.1%, respectively) or West (16.5% vs 13.5%, respectively) region, and have a diagnosis of depression or anxiety (16.4% vs 11.9%, respectively) than patients who did not switch ( < .05 for each). Rates of 30-day ED visits, 90-day adverse events, and 5-year conversion to THA were similar between groups.

CONCLUSION

This large national study found that 62.8% of patients switched surgeons for revision hip arthroscopic surgery and that switching surgeons was associated with clinical factors (anxiety or depression) and nonclinical factors (health insurance and geographic region). Nevertheless, rates of postoperative ED visits, adverse events, and conversion to THA were similar between groups.