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Large Joints Feature

Source: Wikimedia Commons and RRY Publications, LLC

Hip Arthroscopy Complication Rates…3X Higher

Elizabeth Hofheinz, M.P.H., M.Ed. • Wed, June 14th, 2017

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Researchers from Stanford University have determined that we are way off base when it comes to accurate estimates of complication rates in total hip arthroscopy.

Their study, “Complication Rates for Hip Arthroscopy Are Underestimated: A Population-Based Study,” was published in the June 2017 edition of Arthroscopy.

Marc Safran, M.D. is an orthopedic surgeon with Stanford University in Redwood City, California. He and his colleagues utilized PearlDiver, a database containing 18 million Humana Health Care patients (private insurance and Medicare Advantage charge data) to identify patients who had hip arthroscopy between 2007 and 2014.

The authors wrote, “Higher major complication rates after hip arthroscopy were observed using a national payer-based database than previously reported in the literature, especially in regard to hip dislocations and proximal femur fractures. Rates of total hip arthroplasty were similar to prior studies, whereas the rates of revision hip arthroscopy were higher.”

Dr. Safran told OTW, “The key to this paper, which is an analysis of a large insurance database, is that the rates of major complications is significantly higher than what is generally in the literature. I believe this is because what is published in the literature is from high volume centers and physicians who do a lot of hip arthroscopy and have done them for a long time.”

“The data suggests, though we do not have any real idea of the surgeons’ experience level, is that in the community, amongst surgeons who are not doing a high volume of hip arthroscopy, there is a very high complication rate of major complications, such as hip fracture, dislocation and DVT [deep vein thrombosis].”

“The rates are more than triple of most publications. This may explain the discrepancy between what insurance companies believe to be true, and what the high volume hip arthroscopists have found in their practices. Hip arthroscopy done in high volume centers by experienced hip arthroscopists appear to have a lower rate of complications and that does benefit the patient.”

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