Trends in Adolescent Hip Arthroscopy From the PHIS Database: 2008 to 2018

Abstract

Background: Previous studies have suggested that hip arthroscopy has been performed with increasing frequency. Few studies have examined this trend in the adolescent population. Purpose: The purpose of this study was to evaluate the trend in the frequency of hip arthroscopy in adolescents standardized by total orthopaedic surgeries in adolescents at pediatric hospitals in the United States. Methods: The Pediatric Health Information System (PHIS) database was queried for patients aged 10 to 19 years who underwent orthopaedic surgery at any of the PHIS-participating hospitals from 2008 to 2018. The subgroup of patients in this age cohort who underwent hip arthroscopy was identified using Current Procedural Terminology (CPT) procedure codes. The yearly rate was expressed as the number of hip arthroscopies per 1000 orthopaedic surgeries. A linear model was used to fit the data and illustrate the relative trend. Results: A total of 432309 orthopaedic surgeries including 9491 hip arthroscopies were performed for patients 10 to 19 years of age. Hip arthroscopies were performed at a yearly rate of 22 per 1000 orthopaedic surgeries. Over the 10-year period, the number of hip arthroscopies increased 6.2-fold, whereas the number of orthopaedic procedures increased 1.6-fold. There was a 3.9-fold increase in hip arthroscopies relative to total orthopaedic surgeries. Conclusion: The number of hip arthroscopic procedures in adolescent patients has increased by 3.9-fold times relative to total orthopaedic surgeries in adolescents over a 10-year span. This finding mirrors the trends in the adult population over similar time periods. This may be due to increasing participation in sports in the adolescent population as well as a better understanding of the diagnosis and treatment of femoroacetabular impingement and other sports-related hip pathologies. [Table: see text][Figure: see text]

Do All Pediatric Femoral Shaft Fractures Need a Computed Tomography Scan of the Ipsilateral Femoral Neck? Calculating the Incidence of Concomitant Femoral Neck and Shaft Fractures

“…However, our conclusions should be interpreted in light of several limitations. Although the PHIS database has been utilized in many pediatric orthopaedic studies, [31][32][33] there are some inherent limitations to a multicenter database of this nature. One major limitation seen when using the PHIS database is related to the coding nuances/accuracy, the accuracy of the diagnosis was not able to be confirmed and the laterality is not always accounted for.…”

What’s New in Pediatric Orthopaedics

“…Hassan et al queried the Pediatric Health Information System (PHIS) Database for patients who underwent hip arthroscopy and were between 10 and 19 years of age and found that, over 10 years, the number of hip arthroscopies had a 3.9-fold increase compared with the number of total orthopaedic surgical procedures in adolescents. The authors postulated that this increase may be due to improved understanding of hip pathology and increasing sports participation 59 . Hanke et al found that 52% of hockey players enrolled in a longitudinal MRI study at the ages of 12 and 13 years developed cam morphology within 3 years.…”

Issues With Big Data: Variability in Reported Demographics and Complications Associated With Posterior Spinal Fusion in Pediatric Patients

“…However, variations in reporting still exist among participating institutions as the way they report CPT and ICD-9/10 codes for particular procedures or diagnoses may vary. The PHIS database gathers data from large tertiary care referral pediatric hospitals, so the patient population it represents may not be generalizable to the community or nonspecialty hospitals 13,23…”

“…The PHIS database gathers data from large tertiary care referral pediatric hospitals, so the patient population it represents may not be generalizable to the community or nonspecialty hospitals. 13,23 Each database has its strengths and weaknesses, and by exploring their differences, we may be able to identify which databases are more suitable in answering certain research questions. To our knowledge, there are no studies assessing differences in patients, data, and outcomes between these 3 commonly used databases.…”