Abstract
Introduction
Hip arthroscopy is a relatively new procedure and evidence to support its use remains limited. Well-designed prospective clinical trials with long-term outcomes are required, but study design requires an understanding of current practice. Our aim was to determine temporal trends in the uptake of non-arthroplasty hip surgery in England between 2001 and 2011.
Methods
Using procedure and diagnosis codes, we interrogated the Hospital Episode Statistics (HES) Database for all hip procedures performed between 2001 and 2011, excluding those relating to arthroplasty, tumour or infection. Osteotomy procedures were also excluded.
Results
Between 2001 and 2011, 12,684 joint-preserving hip procedures were recorded, of which 5,133 were performed open and 7,551 arthroscopically. The number of arthroscopic hip procedures performed each year increased by 631%, from 263 in 2001, to 1660 in 2011. The number of open procedures performed increased by 271%, from 260 in 2001, to 785 in 2011. The median age-group was 35–39 years of age and 60% of patients were female. There was considerable variation in procedure rates between different Strategic Health Authorities. In 2011, the greatest number of joint-preserving hip procedures were performed in the South West at 9.4 per 100,000 population, whereas the least were performed in the North East at 2.3 per 100,000 population. The proportion of procedures performed arthroscopically was highest in the North West at 75%, and lowest in the East Midlands at 44%.
Conclusions
The number of joint-preserving hip procedures performed has risen significantly between 2001 and 2011, with an exponential rise in the number performed arthroscopically since 2006. Well-designed multi-centre clinical trials are essential to justify these relatively new procedures. If this growth continues, these procedures are likely to represent a significant commissioning burden in the future. HES data is limited since it does not include data from the Private Sector.
