Ngo Ambrose Loc T, Dykhouse Gabrielle, Manes Taylor J, McKegg Phillip C, Sabet Cameron J, Barthman Brett, Golden Robert
College of Osteopathic Medicine, Kansas City University, Joplin, USA.
School of Medicine, Cornell University, Ithaca, USA.
Cureus. 2025 Jun 28;17(6):e86909. doi: 10.7759/cureus.86909. eCollection 2025 Jun.
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.
引言
髋关节脱位是一种严重的损伤，需要紧急干预以尽量减少严重并发症的发生。本研究旨在评估1990年至2019年美国髋关节脱位的流行病学情况。
方法
本研究是一项描述性回顾性流行病学研究。利用全球疾病负担（GBD）数据库收集1990年至2019年美国髋关节脱位的流行病学数据。数据包括伤残调整生命年（YLDs）、患病率以及每10万人的发病率。根据美国人口普查定义，数据按地区分为东北部、中西部、南部和西部。使用Bartlett检验评估方差齐性。进行Welch方差分析以评估区域差异，从而在不假定方差齐性或样本量相等的情况下比较不同组的均值。使用Games-Howell事后检验比较各地区。进行独立t检验以比较男性和女性各项指标的均值。统计学显著性定义为p<0.05，分析使用IBM SPSS Statistics软件29.0.2.0版（IBM公司，纽约州阿蒙克）进行。
结果
从1990年到2019年，在这29年中，美国髋关节脱位的伤残调整生命年平均率下降了1.67%，平均患病率下降了0.32%，平均发病率下降了4.74%。在全国范围内，男性的伤残调整生命年、发病率和患病率的平均率高于女性，不过只有发病率具有统计学显著性（p<0.001）。西部地区髋关节脱位的伤残调整生命年、患病率和发病率的平均率最高，而东北部地区最低。在中西部（p=0.001）、南部（p<0.001）和西部（p=0.004）地区，男性的伤残调整生命年平均率较高。在南部地区男性的平均患病率较高（p=0.007），但在其他地区并非如此。
结论
从1990年到2019年，美国髋关节脱位的平均发病率、患病率和疾病负担总体下降，在所有指标上男性始终显示出比女性更高的比率。在区域方面，美国西部的平均率最高，而美国东北部最低。我们关于区域和性别差异的总体研究结果凸显了进一步制定针对性预防策略的必要性。
