Hip arthroscopy trends and early postoperative outcomes: A National Surgical Quality Improvement Program study from 2014-2023

BACKGROUNDHip arthroscopy has become increasingly popular due to its minimally invasive nature and favorable outcomes compared to open procedures.Despite its growth, national data on surgical volume and complication trends over the past decade remain limited. AIMTo report the case proportion trends of hip arthroscopies from 2014 to 2023 using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database, risk of any adverse events, and patient-related risk factors that increase perioperative complications. METHODSA retrospective analysis was conducted using the ACS-NSQIP database from 2014 to 2023.Patients who underwent hip arthroscopy were identified via current procedural terminology codes.Demographic, clinical, and perioperative variables were extracted.Complications within 30 days postoperatively were categorized as major or minor.Descriptive statistics and regression analyses were performed to identify predictors of adverse events. RESULTSA total of 3,349 hip arthroscopy cases were analyzed.The overall 30-day complication rate was 5.58%, with 1.88% major and 3.70% minor complications.The most common major complication was return to the operating room (0.48%), while bleeding requiring transfusion (2.12%) was the most frequent minor complication.Multivariate analysis revealed that preoperative transfusion, partial dependence in functional status, higher American Society of Anesthesiologists (ASA) class, and regional anesthesia were 4 / 26 significantly associated with increased complication risk.Male sex was associated with decreased risk.Surgical volume showed an overall upward trend from 2014 to 2022, with a slight decline in 2023. CONCLUSIONHip arthroscopy utilization has fluctuated over the past decade.While the procedure remains relatively safe, identifying risk factors such as ASA class, anesthesia type, and functional status is critical for optimizing outcomes.These findings provide updated benchmarks and highlight areas for targeted improvement in perioperative care.