Increased Use of Hip Arthroscopy in the United States from 2015 to 2023 and Projected Growth Through 2030

Abstract

Purpose

To assess hip arthroscopy epidemiology in the United States from 2015 to 2023 and provide projections through 2030, as well as analyze rates of postoperative complications.

Methods

The TriNetX/U.S. Collaborative Networks database was used to identify patients aged 10 to 89 years who underwent hip arthroscopy in the United States from 2015 to 2023. Demographic information, such as age, sex, and body mass index, was analyzed. Prevalence (P), incidence proportion (IP), and incidence rate (IR) were measured. Regression modeling was used to project through 2030. Complications such as femoral neck fracture, hemarthrosis, septic arthritis, hip dislocation/instability, avascular necrosis, osteoarthritis (OA), and conversion to total hip arthroplasty (THA) were also analyzed.

Results

In TriNetX, 25,903 patients underwent hip arthroscopy in the United States from 2015 to 2023. In 2023, 2,427 hip arthroscopies occurred, a 97% increase compared with 1,236 in 2015. Annual database incidence is projected to increase to more than 4,800 cases by 2030. In 2023, prevalence was greatest in female patients aged 20 to 24 years, whereas incidence was greatest in female patients aged 15 to 19 years. Femoral neck fracture, hip dislocation, septic arthritis, and avascular necrosis occurred in <1% of patients within 2 and 5 years postoperatively. Male patients had greater risk for all complications aside from hemarthrosis and trochanteric bursitis, which were greater in female patients at 5 years. In total, 17% of patients developed OA, with 9.8% requiring conversion to THA within 5 years. Most (>80%) who converted to THA were older than 30 years of age at time of hip arthroscopy. There were no sex-based differences in conversion to THA.

Conclusions

Our analysis reveals a substantial increase in hip arthroscopy, with projections indicating a continued surge. Despite low complication rates, male patients were found to be at greater risk of most complications aside from hemarthrosis and trochanteric bursitis, which were higher in female patients. The incidence of developing OA and conversion to THA remains significant.

Level of Evidence

Level IV, retrospective case series.