Skip to main content
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 12/2016

01.08.2015 | Hip

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

verfasst von: Darren de SA, Nolan S. Horner, Austin MacDonald, Nicole Simunovic, Gerard Slobogean, Marc J. Philippon, Etienne L. Belzile, Jon Karlsson, Olufemi R. Ayeni

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 12/2016

Einloggen, um Zugang zu erhalten

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.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
2.
Zurück zum Zitat Adla D, Roswell M, Pandey R (2010) Cost-effectiveness of open versus arthroscopic rotator cuff repair. J Shoulder Elbow Surg 19(2):258–261CrossRefPubMed Adla D, Roswell M, Pandey R (2010) Cost-effectiveness of open versus arthroscopic rotator cuff repair. J Shoulder Elbow Surg 19(2):258–261CrossRefPubMed
3.
Zurück zum Zitat Agency for Health Care Research and Quality. HCUPnet: a tool for identifying, tracking and analyzing national hospital statistics. Healthcare Cost and Utilization Project (HCUP). http://hcupnet.ahrq.gov Agency for Health Care Research and Quality. HCUPnet: a tool for identifying, tracking and analyzing national hospital statistics. Healthcare Cost and Utilization Project (HCUP). http://​hcupnet.​ahrq.​gov
4.
Zurück zum Zitat Ayeni O, Chan K, Al-Asiri J, Chien T, Sprague S, Liew S, Bhandari M (2013) Sources and quality of literature addressing femoroacetabular impingement. Knee Surg Sport Traumatol Arthrosc 21(2):415–419CrossRef Ayeni O, Chan K, Al-Asiri J, Chien T, Sprague S, Liew S, Bhandari M (2013) Sources and quality of literature addressing femoroacetabular impingement. Knee Surg Sport Traumatol Arthrosc 21(2):415–419CrossRef
5.
Zurück zum Zitat Boone G, Pagnotto M, Walker J, Trousdale R, Sierra R (2012) Caution Should be Taken in Performing Hip Dislocation for the Treatment of Femoroacetabular Impingement in Patients Over the Age of 40. Musculoskelet J Hosp Spec Surg 8(3):230–234 Boone G, Pagnotto M, Walker J, Trousdale R, Sierra R (2012) Caution Should be Taken in Performing Hip Dislocation for the Treatment of Femoroacetabular Impingement in Patients Over the Age of 40. Musculoskelet J Hosp Spec Surg 8(3):230–234
6.
Zurück zum Zitat Botser I, Jackson T, Smith T, Leonard J, Stake C, Domb B (2014) Open surgical dislocation versus arthroscopic treatment of femoroacetabular impingement. Am J Orthop 43(5):209–214PubMed Botser I, Jackson T, Smith T, Leonard J, Stake C, Domb B (2014) Open surgical dislocation versus arthroscopic treatment of femoroacetabular impingement. Am J Orthop 43(5):209–214PubMed
7.
Zurück zum Zitat Bozic K, Chan V, Valone F, Feeley B, Vail T (2013) Trends in hip arthroscopy utilization in the United States. J Arthroplasty 28(8):140–143CrossRefPubMed Bozic K, Chan V, Valone F, Feeley B, Vail T (2013) Trends in hip arthroscopy utilization in the United States. J Arthroplasty 28(8):140–143CrossRefPubMed
8.
Zurück zum Zitat Clement N, Macdonald D, Gaston P (2014) Hip arthroscopy for femoroacetabular impingement: a health economic analysis. Hip Int 24(5):457–464CrossRefPubMed Clement N, Macdonald D, Gaston P (2014) Hip arthroscopy for femoroacetabular impingement: a health economic analysis. Hip Int 24(5):457–464CrossRefPubMed
9.
Zurück zum Zitat Colvin A, Harrast J, Harner C (2012) Trends in hip arthroscopy. J Bone Joint Surg Am 94(4):e23CrossRefPubMed Colvin A, Harrast J, Harner C (2012) Trends in hip arthroscopy. J Bone Joint Surg Am 94(4):e23CrossRefPubMed
10.
Zurück zum Zitat de SA D, Cargnelli S, Catapano M, Bedi A, Simunovic N, Burrow S, Ayeni O (2014) Femoroacetabular Impingement in Skeletally Immature Patients: a Systematic Review Examining Indications, Outcomes, and Complications of Open and Arthroscopic Treatment. Arthroscopy 31(2):373–384CrossRefPubMed de SA D, Cargnelli S, Catapano M, Bedi A, Simunovic N, Burrow S, Ayeni O (2014) Femoroacetabular Impingement in Skeletally Immature Patients: a Systematic Review Examining Indications, Outcomes, and Complications of Open and Arthroscopic Treatment. Arthroscopy 31(2):373–384CrossRefPubMed
11.
Zurück zum Zitat Dietrich F, Ries C, Eirmann C, Miehlke W, Sobau C (2014) Complications In Hip Arthroscopy: necessity of Supervision During the Learning Curve. Knee Surg Sport Traumatol Arthrosc 22(4):953–958CrossRef Dietrich F, Ries C, Eirmann C, Miehlke W, Sobau C (2014) Complications In Hip Arthroscopy: necessity of Supervision During the Learning Curve. Knee Surg Sport Traumatol Arthrosc 22(4):953–958CrossRef
12.
Zurück zum Zitat Domb B, Stake C, Botser I, Jackson T (2013) Surgical dislocation of the hip versus arthroscopic treatment of femoroacetabular impingement: a prospective matched-pair study with average 2-year follow-up. Arthroscopy 29(9):1506–1513CrossRefPubMed Domb B, Stake C, Botser I, Jackson T (2013) Surgical dislocation of the hip versus arthroscopic treatment of femoroacetabular impingement: a prospective matched-pair study with average 2-year follow-up. Arthroscopy 29(9):1506–1513CrossRefPubMed
13.
Zurück zum Zitat Epstein AJ, Groeneveld PW, Harhay MO, Yang F, Polsky D (2013) Impact of minimally invasive surgery on medical spending and employee absenteeism. JAMA Surg 148(7):641–647CrossRefPubMed Epstein AJ, Groeneveld PW, Harhay MO, Yang F, Polsky D (2013) Impact of minimally invasive surgery on medical spending and employee absenteeism. JAMA Surg 148(7):641–647CrossRefPubMed
14.
Zurück zum Zitat Espinosa N, Beck M, Rothenfluh D, Ganz R, Leunig M (2007) Treatment of femoro-acetabular impingement: preliminary results of labral refixation. J Bone Joint Surg Am 89A(2):36–53CrossRef Espinosa N, Beck M, Rothenfluh D, Ganz R, Leunig M (2007) Treatment of femoro-acetabular impingement: preliminary results of labral refixation. J Bone Joint Surg Am 89A(2):36–53CrossRef
15.
Zurück zum Zitat Ganz R, Parvizl J, Beck M, Leunig M, Notzil H, Siebenrock K (2003) Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res 417(1):112–120 Ganz R, Parvizl J, Beck M, Leunig M, Notzil H, Siebenrock K (2003) Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res 417(1):112–120
16.
Zurück zum Zitat Goto T, Hamada D, Mineta K, Tonogai I, Egawa H, Matsuura T, Takahashi M, Higashino K, Sakai T, Suzue N, Takata Y, Nishisho T, Goda Y, Sato R, Tezuka F, Kondo K, Takeuchi M, Sugiura K et al (2014) The state of the art in arthroscopic hip surgery. J Med Investig 61(3–4):226–232CrossRef Goto T, Hamada D, Mineta K, Tonogai I, Egawa H, Matsuura T, Takahashi M, Higashino K, Sakai T, Suzue N, Takata Y, Nishisho T, Goda Y, Sato R, Tezuka F, Kondo K, Takeuchi M, Sugiura K et al (2014) The state of the art in arthroscopic hip surgery. J Med Investig 61(3–4):226–232CrossRef
17.
Zurück zum Zitat Hoppe D, de Sa D, Simunovic N, Bhandari M, Safran M, Larson C, Ayeni O (2014) The Learning Curve for Hip Arthroscopy: a Systematic Review. Arthroscopy 30(3):389–397CrossRefPubMed Hoppe D, de Sa D, Simunovic N, Bhandari M, Safran M, Larson C, Ayeni O (2014) The Learning Curve for Hip Arthroscopy: a Systematic Review. Arthroscopy 30(3):389–397CrossRefPubMed
18.
Zurück zum Zitat Kowalczuk M, Bhandari M, Farrokhyar F, Wong I, Chahal M, Neely S, Gandhi R, Ayeni O (2013) Complications following hip arthroscopy: a systematic review and meta-analysis. Arthroscopy 21(7):1669–1675 Kowalczuk M, Bhandari M, Farrokhyar F, Wong I, Chahal M, Neely S, Gandhi R, Ayeni O (2013) Complications following hip arthroscopy: a systematic review and meta-analysis. Arthroscopy 21(7):1669–1675
19.
Zurück zum Zitat Kurtz S, Ong K, Laue E, Mowat F, Halpern M (2007) Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am 89(4):780–785PubMed Kurtz S, Ong K, Laue E, Mowat F, Halpern M (2007) Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am 89(4):780–785PubMed
20.
Zurück zum Zitat Larson C, Giveans M (2009) Arthroscopic debridement versus refixation of the acetabular labrum associated with femoroacetabular impingement. Arthroscopy 25(4):369–376CrossRefPubMed Larson C, Giveans M (2009) Arthroscopic debridement versus refixation of the acetabular labrum associated with femoroacetabular impingement. Arthroscopy 25(4):369–376CrossRefPubMed
21.
Zurück zum Zitat Larson C, Giveans M (2008) Arthroscopic management of femoroacetabular impingement: early outcomes measures. Arthroscopy 24(5):540–546CrossRefPubMed Larson C, Giveans M (2008) Arthroscopic management of femoroacetabular impingement: early outcomes measures. Arthroscopy 24(5):540–546CrossRefPubMed
22.
Zurück zum Zitat Martin R, Kelly B, Philippon M (2006) Evidence of validity for the hip outcome score. Arthroscopy 22(8):1304–1311CrossRefPubMed Martin R, Kelly B, Philippon M (2006) Evidence of validity for the hip outcome score. Arthroscopy 22(8):1304–1311CrossRefPubMed
23.
Zurück zum Zitat Matsuda D, Carlisle J, Arthurs S, Wierks C, Philippon M (2011) Comparative systematic review of the open dislocation, mini-open, and arthroscopic surgeries for femoroacetabular impingement. Arthroscopy 27(2):252–269CrossRefPubMed Matsuda D, Carlisle J, Arthurs S, Wierks C, Philippon M (2011) Comparative systematic review of the open dislocation, mini-open, and arthroscopic surgeries for femoroacetabular impingement. Arthroscopy 27(2):252–269CrossRefPubMed
24.
Zurück zum Zitat McGinn T, Wyer P, Newman T, Keitz S, Leipzig R (2004) Tips for learners of evidence-based medicine: 3 measures of observer variability (kappa statistic). Can Med Assoc J 171(11):1369–1373CrossRef McGinn T, Wyer P, Newman T, Keitz S, Leipzig R (2004) Tips for learners of evidence-based medicine: 3 measures of observer variability (kappa statistic). Can Med Assoc J 171(11):1369–1373CrossRef
25.
Zurück zum Zitat Philippon M, Briggs K, Yen Y, Kuppersmith D (2009) Outcomes following hip arthroscopy for femoroacetabular impingement with associated chondrolabral dysfunction: minimum two-year follow-up. J Bone Joint Surg Br 91(1):16–23CrossRefPubMed Philippon M, Briggs K, Yen Y, Kuppersmith D (2009) Outcomes following hip arthroscopy for femoroacetabular impingement with associated chondrolabral dysfunction: minimum two-year follow-up. J Bone Joint Surg Br 91(1):16–23CrossRefPubMed
26.
Zurück zum Zitat Ribas M, Ledesma R, Cardenas C, Marin-Pena O, Toro J, Caceres E (2010) Clinical results after anterior mini-open approach for femoroacetabular impingement in early degenerative stage. Hip Int 20(7):36–42CrossRef Ribas M, Ledesma R, Cardenas C, Marin-Pena O, Toro J, Caceres E (2010) Clinical results after anterior mini-open approach for femoroacetabular impingement in early degenerative stage. Hip Int 20(7):36–42CrossRef
28.
Zurück zum Zitat Shearer D, Kramer J, Bozic K, Feeley B (2012) Is hip arthroscopy cost-effective for femoroacetabular impingement? Clin Orthop Relat Res 470(4):1079–1089CrossRefPubMed Shearer D, Kramer J, Bozic K, Feeley B (2012) Is hip arthroscopy cost-effective for femoroacetabular impingement? Clin Orthop Relat Res 470(4):1079–1089CrossRefPubMed
29.
Zurück zum Zitat Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J (2003) Methodological index for non-randomized studies (MINORS): development and validation of a new instrument. ANZ J Surg 73(9):712–716CrossRefPubMed Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J (2003) Methodological index for non-randomized studies (MINORS): development and validation of a new instrument. ANZ J Surg 73(9):712–716CrossRefPubMed
30.
Zurück zum Zitat Tran P, Pritchard M, O’Donnell J (2013) Outcome of arthroscopic treatment for cam type femoroacetabular impingement in adolescents. ANZ J Surg 83(5):382–386CrossRefPubMed Tran P, Pritchard M, O’Donnell J (2013) Outcome of arthroscopic treatment for cam type femoroacetabular impingement in adolescents. ANZ J Surg 83(5):382–386CrossRefPubMed
31.
Zurück zum Zitat Zaltz I, Kelly BT, Larson CM, Leunig M, Bedi A (2014) Surgical treatment of femoroacetabular impingement: what are the limits of hip arthroscopy? Arthroscopy 30(1):99–110CrossRefPubMed Zaltz I, Kelly BT, Larson CM, Leunig M, Bedi A (2014) Surgical treatment of femoroacetabular impingement: what are the limits of hip arthroscopy? Arthroscopy 30(1):99–110CrossRefPubMed
Metadaten
Titel
Evaluating healthcare resource utilization and outcomes for surgical hip dislocation and hip arthroscopy for femoroacetabular impingement
verfasst von
Darren de SA
Nolan S. Horner
Austin MacDonald
Nicole Simunovic
Gerard Slobogean
Marc J. Philippon
Etienne L. Belzile
Jon Karlsson
Olufemi R. Ayeni
Publikationsdatum
01.08.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 12/2016
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-015-3722-5

Weitere Artikel der Ausgabe 12/2016

Knee Surgery, Sports Traumatology, Arthroscopy 12/2016 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.