Early experience with a comprehensive hip preservation service intended to improve clinical care, education, and academic productivity.

Abstract

The field of hip preservation surgery has grown substantially over the past decade. Although open hip procedures reportedly relieve pain and restore function, arthroscopic treatment has increasingly become a reasonable alternative. In 2008, we formed a comprehensive hip preservation service (HPS) to address clinical, educational, and research needs. We compared (1) volume, type, and corresponding improvement in pain and function of open and arthroscopic treatments; (2) orthopaedic resident test performance; and (3) academic productivity before and after creation of the HPS. We retrospectively reviewed 212 patients undergoing 220 open procedures from 1996 to 2007 (Group 1) and 260 patients undergoing 298 procedures (153 open, 145 arthroscopic) from 2008 to May 2010 (Group 2). At each clinic visit, we recorded Harris hip score (HHS) and conversion to THA. Minimum followup was 1 year for Group 1 (mean, 4 years; range, 1-13 years) and Group 2 (mean, 1.5 years; range, 1-3 years). We compared orthopaedic resident performance on two standardized tests and the number of academic works (publications, book chapters, electronic media) and peer-reviewed grants funded before and after creation of the HPS. Mean HHS improved from 63 to 90 in Group 1 and from 76 to 91 in Group 2. Rate of conversion to THA was similar between groups despite expansion of surgical volume. Standardized orthopaedic resident test performance improved. Academic productivity as measured by publications and grant funding was facilitated by the HPS. Early experience with a multidisciplinary HPS was positive; it facilitated clinical volume expansion while maintaining improvement in pain and function in young adults. Additional benefits included educational and academic productivity gains. Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.