Rapid decline of yearly number of hip arthroscopies in Sweden: a retrospective time series of 6,105 hip arthroscopies based on a national patient data register

Trends in hip preservation surgery in Japan from 2014 to 2019 with a focus on hip arthroscopic surgery

Secondary hip osteoarthritis due to hip dysplasia is common among Japanese populations. This study aimed to investigate the number of hip preservation surgeries performed in Japan and assess trends, by age and sex, from 2014 to 2019, focusing on hip arthroscopic surgery, based on the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB). We downloaded the files 'Number of calculations by division, sex, and age group' under 'operation (code K)' from 2014 to 2019 from the NDB Open Data Japan database. Data on hip preservation surgeries were extracted, including the number for each surgical procedure and its incidence per year, calculated as the number of surgeries performed for each 10-year age group and by sex, regarding hip arthroscopic surgery. Overall, 14 891 hip preservation surgeries were performed in Japan over the study period, with pelvic osteotomy being the most common procedure. Although the incidence of hip preservation surgeries decreased from 2014 to 2019, there was a specific 1.54-fold higher incidence in hip arthroscopic procedures in 2019 compared to 2014. Hip arthroscopic labral repair was performed more frequently than synovectomy. The highest incidence of hip arthroscopic surgery was in the 40- to 49-years age group, with no difference in incidence between sexes (P = 0.951). In Japan, pelvic osteotomy was performed more often as a hip preservation surgery than hip arthroscopic surgery. Although hip arthroscopic surgery was developed in Japan, its use has not increased from 2017 to 2019.

THE STATE OF HIP ARTHROSCOPY IN RUSSIA: ASSESSMENT BASED ON A SOCIOLOGICAL SURVEY OF DOCTORS

Background.Hip arthroscopy is a minimally invasive surgical technique most commonly performed to correct femoroacetabular impingement (FAI). The number of hip arthroscopy performed in Russia is unknown. Information about this surgical technique is also very limited in our country.The aim of the study was to assess the level of hip arthroscopy in Russia.Methods.A sociological survey of orthopaedic surgeon with experience in performing hip arthroscopy was conducted. The questionnaire was posted on the Google Forms platform. The survey included 54 surgeons from Russian clinics, 45 people filled out the questionnaire.Results.The majority of specialists (73,30,06%) were trained in hip arthroscopy. More than half of the respondents (68,80,06%) are currently engaged in this surgical area, however, in 45,160,07% of them, the number of operations does not exceed 5 per year. For surgeons who have completed two or more training courses, the volume of operations performed is higher (p0,05). 51,110,07% of doctors perform arthroscopy using an alternative technique. There are 2,5 time more specialists doing just bone resection, than surgeons who apply any kind of reconstruction technique while treating FAI (p0,05). Fifteen respondents (48,390,08%) perform debridement as an attempt to delay arthroplasty. The most common difficulties faced by surgeon are problems with the diagnosis of FAI (400,02%), lack of the necessary tools (400,02%) and sufficient time to master the technique (33,30,07%). Only three (6,60,07%) respondents believed to achieve planned results, 93,30,03% of surgeons said that it is not always possible to achieve the desired outcomes.Conclusion. Hip arthroscopy in Russia is not very common, the volume of such interventions is insignificant. Doctors not skilled in arthroscopic hip surgery predominate. Factors impeding the development of this area in our country are related to teaching methods, FAI diagnostics, the lack of necessary instruments for performing operations, and the lack of time for specialists to master surgical techniques.