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Evaluating healthcare resource utilization and outcomes for surgical hip dislocation and hip arthroscopy for femoroacetabular impingement

  • Hip
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Surgical hip dislocation (SHD) and hip arthroscopy are surgical methods used to correct deformity associated with femoroacetabular impingement (FAI). Though both of these approaches appear to benefit patients, no studies exist comparing healthcare resource utilization of the two surgical approaches. This systematic review examines the literature and the records of two surgeons to evaluate the resource utilization associated with treating symptomatic FAI via these two methods.

Methods

EMBASE, MEDLINE and PubMed were searched for relevant articles. The articles were systematically screened, and data was abstracted in duplicate. To further supplement resource utilization data, a retrospective chart review of two surgeon’s patient data (one using SHD and another using an arthroscopic approach) was completed. Experts in pharmacy, physiotherapy, radiology, anaesthesia, physiatry and the local hospital finance department were also consulted.

Results

There were 52 studies included with a total of 460 patients (535 hips) and 3886 patients (4147 hips) who underwent SHD and arthroscopic surgery for FAI, respectively. Regardless of approach, most patients treated for symptomatic FAI improved across various outcomes measures with low complication rates. Surgical time across all approaches was similar, averaging 118 ± 2 min. On a per patient basis, hip arthroscopy ($10,976) uses approximately 41 % of the resources of SHD ($24,379).

Conclusion

There were no significant differences in outcomes for FAI treated with SHD or arthroscopy. However, with regard to healthcare resource utilization based on the OHIP healthcare system, hip arthroscopy uses substantially less resources than SHD within the first post-operative year.

Level of evidence

Systematic Review of Level IV Studies, Level IV.

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Authors and Affiliations

  1. Division of Orthopaedic Surgery, Department of Surgery, McMaster University Medical Center, McMaster University, 1200 Main Street West, Room 4E15, Hamilton, ON, L8N 3Z5, Canada

    Darren de SA, Gerard Slobogean & Olufemi R. Ayeni

  2. Michael G. DeGroote School of Medicine, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada

    Nolan S. Horner & Austin MacDonald

  3. Department of Clinical Epidemiology and Biostatistics, Centre for Evidence Based Orthopaedics, McMaster University, 293 Wellington St. N, Suite 110, Hamilton, ON, L8L 8E7, Canada

    Nicole Simunovic

  4. The Steadman Clinic, 181 West Meadow Drive, Suite 400, Vail, CO, 81657, USA

    Marc J. Philippon

  5. Division of Orthopaedic Surgery, CHUQ-Hotel Dieu de Quebec, Quebec, QC, Canada

    Etienne L. Belzile

  6. The department of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

    Jon Karlsson

Authors
  1. Darren de SA
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  2. Nolan S. Horner
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  3. Austin MacDonald
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  4. Nicole Simunovic
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  5. Gerard Slobogean
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  9. Olufemi R. Ayeni
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Correspondence to Olufemi R. Ayeni.

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de SA, D., Horner, N.S., MacDonald, A. et al. Evaluating healthcare resource utilization and outcomes for surgical hip dislocation and hip arthroscopy for femoroacetabular impingement. Knee Surg Sports Traumatol Arthrosc 24, 3943–3954 (2016). https://doi.org/10.1007/s00167-015-3722-5

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  • DOI: https://doi.org/10.1007/s00167-015-3722-5

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