Epidemiology of Hip Dislocations in the United States From 1990 to 2019: A Temporal Study Using the Global Burden of Disease Database.

Introduction Hip dislocations are devastating injuries that require urgent intervention to minimize the development of severe complications. This study aimed to evaluate the epidemiology of hip dislocations in the United States (U.S.) from 1990 to 2019.  Methods This study is a descriptive retrospective epidemiological study. The Global Burden of Disease (GBD) database was used to collect epidemiological data on hip dislocation in the U.S. from 1990 to 2019. Data included years lived with disability (YLDs), prevalence, and incidence rates per 100,000 people. Data were regionally stratified into Northeast, Midwest, South, and West by the U.S. Census definition. Bartlett's test was used to assess equal variance. Welch's ANOVA was performed to assess regional differences to compare the means of different groups without assuming equal variances or equal sample sizes. The Games-Howell post hoc test was used to compare regions. Independent t-tests were performed to compare the means of each measure between males and females. Statistical significance was defined as p<0.05, and analyses were performed using IBM SPSS Statistics software, version 29.0.2.0 (IBM Corp., Armonk, NY).  Results From 1990 to 2019, the U.S. saw a 1.67% decrease in the mean rate of YLDs, a 0.32% decrease in the mean prevalence rate, and a 4.74% decrease in the mean incidence rate of hip dislocations over the 29 years. Nationally, men experienced higher mean rates of YLDs, incidence, and prevalence compared to women, though only incidence was statistically significant (p<0.001). The Western region had the highest mean rates of YLDs, prevalence, and incidence rates of hip dislocation, while the Northeastern region experienced the lowest. Men had higher mean rates of YLDs in the Midwest (p=0.001), South (p<0.001), and West (p=0.004) regions. Men had a higher mean prevalence rate in the South (p=0.007), but not in other regions.  Conclusions From 1990 to 2019, the U.S. experienced an overall drop in mean incidence, prevalence, and disease burden of hip dislocations, with men consistently showing higher rates across all measures compared to women. Regionally, the Western U.S. had the highest mean rates, while the Northeastern U.S. had the lowest. Our overall findings on the regional and sex-based disparities highlight the need for further targeted prevention strategies.