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Arthroscopy for Management of Femoroacetabular Impingement Syndrome in the Military Health System: A 10-Year Epidemiological Overview of Cases with 2-year Follow-up.

Publication ,  Journal Article
Rhon, D; Schmitz, M; Mayhew, R; Dry, K; Greenlee, T
Published in: Mil Med
December 1, 2019

INTRODUCTION: With the rapid rise in arthroscopy rates for the management of Femoroacetabular Impingement (FAI) Syndrome, it is important to understand current surgical rates and the impact of these surgeries within the Military Health System (MHS). The purpose of this study was to provide an epidemiological descriptive summary of hip arthroscopy for FAI Syndrome in the MHS and describe perioperative healthcare utilization variables. METHODS: Eligible beneficiaries ages 18-50, undergoing hip arthroscopy with 2-year follow-up after surgery were included. Healthcare utilization data were abstracted from the MHS Data Repository (MDR) from June 2003 to July 2015, and included all visits, costs, procedures, and prescriptions taking place in both military and civilian hospitals worldwide. RESULTS: 1870 patients were included (mean age 32.2 years; 55.5% male). 51.7% of the procedures took place in military versus 48.3% in civilian hospitals. Mean hip-related healthcare costs in the 2-year following surgery were $15,434 per patient. Patients had a median of 3 opioid prescriptions and 72% had a comorbidity present after surgery. Generally, rates of surgery grew annually from 66 cases in 2004 to 422 cases in 2013. Overall complication rates were comparable to other published reports. Procedures in both military and civilian hospitals had the same rates of femoroplasty and labral repairs, however acetabuloplasty procedures occurred at a higher rate in military (18.9%) vs civilian (14.7%) hospitals. Only 58.8% of patients had physical therapy in the year prior to surgery, while 82.7% had it after surgery. Additionally, 50% of patients had received opioid prescriptions in the 1 year prior to surgery, while 38.9% had 3 or greater opioid prescriptions beyond the initial perioperative fill within the 2-year follow-up. CONCLUSION: Rates of arthroscopy have grown in the MHS over the last decade. Complication rates are similar to those reported in other populations and settings. Utilization of physical therapy was much more likely after surgery than prior to it. Opioid use was high prior to surgery and many individuals continued to receive opioid prescriptions beyond the initial perioperative period.

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Published In

Mil Med

DOI

EISSN

1930-613X

Publication Date

December 1, 2019

Volume

184

Issue

11-12

Start / End Page

788 / 796

Location

England

Related Subject Headings

  • United States
  • Treatment Outcome
  • Strategic, Defence & Security Studies
  • Postoperative Period
  • Military Medicine
  • Middle Aged
  • Male
  • Humans
  • Follow-Up Studies
  • Femoracetabular Impingement
 

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Rhon, D., Schmitz, M., Mayhew, R., Dry, K., & Greenlee, T. (2019). Arthroscopy for Management of Femoroacetabular Impingement Syndrome in the Military Health System: A 10-Year Epidemiological Overview of Cases with 2-year Follow-up. Mil Med, 184(11–12), 788–796. https://doi.org/10.1093/milmed/usz057
Rhon, Daniel, Matthew Schmitz, Rachel Mayhew, Katie Dry, and Tina Greenlee. “Arthroscopy for Management of Femoroacetabular Impingement Syndrome in the Military Health System: A 10-Year Epidemiological Overview of Cases with 2-year Follow-up.Mil Med 184, no. 11–12 (December 1, 2019): 788–96. https://doi.org/10.1093/milmed/usz057.
Rhon, Daniel, et al. “Arthroscopy for Management of Femoroacetabular Impingement Syndrome in the Military Health System: A 10-Year Epidemiological Overview of Cases with 2-year Follow-up.Mil Med, vol. 184, no. 11–12, Dec. 2019, pp. 788–96. Pubmed, doi:10.1093/milmed/usz057.

Published In

Mil Med

DOI

EISSN

1930-613X

Publication Date

December 1, 2019

Volume

184

Issue

11-12

Start / End Page

788 / 796

Location

England

Related Subject Headings

  • United States
  • Treatment Outcome
  • Strategic, Defence & Security Studies
  • Postoperative Period
  • Military Medicine
  • Middle Aged
  • Male
  • Humans
  • Follow-Up Studies
  • Femoracetabular Impingement