EP6.53 Temporal trends and geographical variation of arthroscopic hip surgery in England from 2010 to 2023

Introduction: The utilisation of arthroscopic hip surgery to treat pathologies like femoroacetabular impingement and labral tears was predicted to rise by 1388% from 2002 to 2023. Understanding the current trends and geographical variation in hip arthroscopy (HA) provision is important to optimise healthcare resources across health services. We aimed to (1) analyse the temporal trends and (2) examine the geographical variation of arthroscopic hip surgery in England from 2010 to 2023.

Methods: We performed a retrospective observational study analysing national data from the Hospital Episode Statistics (HES) database in England. We extracted anonymised records of patients who underwent HA between April 2010 and March 2023, using specific OPCS-4 codes ‘W83+Z843ʹ or ‘W84+Z843ʹ. We collected patient demographics including age, sex and region of treatment. The primary outcome was the annual count of HA procedures. Descriptive analysis was performed using Excel and GraphPad Prism, with regional data adjusted for population size to evaluate the temporal trends of HA by age and sex, at a national and regional level.

Results: In total, 22,401 patients who underwent HA between 2010 and 2023 were identified from the HES database. The annual number of HA procedures declined by 28.4% over the study period. After an initial increase of 104% from 2010/11 to 2014/15, the rates dropped by 65.4% from 2014/15 to 2022/23. Females represented 61.3% of all patients, with a higher mean age (36.8±12.0 years) than males (35.8±11.2 years). The mean age of both genders decreased by 3.3 and 2.9 years respectively over the study period. In 2022/23, the overall mean regional incidence of HA was 1.60 per 100,000 - ranging from 0.70 to 2.66 per 100,000, representing a 3.8-fold difference.

Conclusion: Our study shows a significant decline in the volume of HA in England over the past decade, with significant geographical variation. This could be explained by improved patient selection based on recent evidence from clinical trials and registry-based studies, together with the impact of reduced elective services during COVID-19. However, these evolving utilisation trends have broader implications for healthcare systems, highlighting the need for efficient resource allocation to reduce inequalities and improve training opportunities.