Hip arthroscopy in Sweden: a nationwide registry study of socioeconomic characteristics, regional variation, and sick leave patterns
DOI:
https://doi.org/10.2340/17453674.2026.46648Keywords:
Arthroscopy, health equity, hip, workabilityAbstract
Background and purpose: Clinical outcomes are well described after hip arthroscopy (HA), but less is known about the demographic, socioeconomic, and work-related characteristics of individuals undergoing the procedure at a population level. We aimed to describe demographic, socioeconomic, and regional characteristics of individuals undergoing HA in Sweden based on nationwide registry data compared with an age- and sex-matched reference population, and to describe regional variation in the annual incidence of HA using nationwide registry data.
Methods: We conducted a nationwide descriptive registry study including all individuals aged 18–65 years who underwent HA in Sweden between 2006 and 2018. Each individual was matched by sex and year of birth to 5 reference individuals from the general population. National registers provided information on demographics, region of residence, education, citizenship, employment status, income, and compensated sick leave.
Results: The study included 4,633 individuals undergoing HA and 23,060 matched reference individuals. Mean age was 36 years, and 3,019/4,633 (65%) were men. Residence-based HA incidence was highest in metropolitan and nearby counties. Individuals undergoing HA more often had post-secondary education (1,874/4,633 [40%] vs 8,003/23,060 [35%]), employment before surgery (4,299/4,633 [93%] vs 19,267/23,060 [84%]), and high-income levels (1,996/4,633 [43%] vs 7,358/23,060 [32%]) than the reference population. Compensated sick leave was more common among individuals undergoing HA both before surgery (741/4,633 [16%] vs 1,614/23,060 [7%]) and during the year after surgery (1,436/4,633 [31%] vs 1,845/23,060 [8%]).
Conclusion: Individuals undergoing HA were more often employed and belonged to higher-income groups than a matched reference population. HA incidence varied substantially between regions, and individuals undergoing HA demonstrated higher levels of compensated sick leave both before and after surgery.
Downloads
References
Frank J M, Harris J D, Erickson B J, Slikker III W, Bush-Joseph C A, Salata M J, et al. Prevalence of femoroacetabular impingement imaging findings in asymptomatic volunteers: a systematic review. Arthroscopy 2015; 31(6): 1199-204. doi: 10.1016/j.arthro.2014.11.042.
Griffin D R, Dickenson E J, O’Donnell J, Agricola R, Awan T, Beck M, et al. The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement. Br J Sports Med 2016; 50(19): 1169-76. doi: 10.1136/bjsports-2016-096743.
Sansone M, Ahldén M, Jonasson P, Thomeé C, Swärd L, Baranto A, et al. A Swedish hip arthroscopy registry: demographics and development. Knee Surg Sports Traumatol Arthrosc 2014; 22(4): 774-80. doi: 10.1007/s00167-014-2840-9.
Maradit Kremers H, Schilz S R, Van Houten H K, Herrin J, Koenig K M, Bozic K J, et al. Trends in utilization and outcomes of hip arthroscopy in the United States between 2005 and 2013. J Arthroplasty 2017; 32(3): 750-5. doi: 10.1016/j.arth.2016.09.004.
Nepple J J, Vigdorchik J M, Clohisy J C. What is the association between sports participation and the development of proximal femoral cam deformity? A systematic review and meta-analysis. Am J Sports Med 2015; 43(11): 2833-40. doi: 10.1177/0363546514563909.
Palmer A J R, Malak T T, Broomfield J, Holton J, Majkowski L, Thomas G E R, et al. Past and projected temporal trends in arthroscopic hip surgery in England between 2002 and 2013. BMJ Open Sport Exerc Med 2016; 2(1): e000082. doi: 10.1136/bmjsem-2015-000082.
Wörner T, Eek F, Kraus-Schmitz J, Sansone M, Stålman A. 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. Acta Orthop 2021; 92(5): 562-7. doi: 10.1080/17453674.2021.1928396.
McCulloch P, Altman D G, Campbell W B, Flum D R, Glasziou P, Marshall J C, et al. No surgical innovation without evaluation: the IDEAL recommendations. Lancet 2009; 374(9695): 1105-12. doi: 10.1016/S0140-6736(09)61116-8.
Mascarenhas V V, Rego P, Dantas P, Morais F, McWilliams J, Collado D, et al. Imaging prevalence of femoroacetabular impingement in symptomatic patients, athletes, and asymptomatic individuals: a systematic review. Eur J Radiol 2016; 85(1): 73-95. doi: 10.1016/j.ejrad.2015.10.016.
Blaeser A M, Mojica E S, Mannino B J, Youm T. Return to work after primary hip arthroscopy: a systematic review and meta-analysis. Am J Sports Med 2023; 51(5): 1340-6. doi: 10.1177/03635465211064271.
Ifabiyi M, Patel M, Cohen D, Simunovic N, Ayeni O R. Return-to-sport rates after hip arthroscopy for femoroacetabular impingement syndrome in flexibility sports athletes: a systematic review. Sports Health 2024; 16(6): 982-90. doi: 10.1177/19417381231217503.
Kotlier J L, Fathi A, Kumaran P, Mayfield C K, Orringer M, Liu J N, et al. Demographic and socioeconomic patient data are rarely included in randomized controlled trials for femoral acetabular impingement and hip arthroscopy: a systematic review. Arthrosc Sports Med Rehabil 2024; 6(2): 100901. doi: 10.1016/j.asmr.2024.100901.
Lee S, Cvetanovich G L, Mascarenhas R, Wuerz T H, Mather RC, Bush-Joseph C A, et al. Ability to return to work without restrictions in workers compensation patients undergoing hip arthroscopy. J Hip Preserv Surg 2016; 4(1): 30-8. doi: 10.1093/jhps/hnw037.
Prabhavalkar O N, Carbone A D, Bruning R E, Domb E S, Maldonado D R. Effect of socioeconomic status on outcomes after hip arthroscopy: minimum 5-year follow-up. Am J Sports Med 2025; 53(14): 3347-55. doi: 10.1177/03635465251383908.
Ramadanov N, Lettner J, Voss M, Prill R, Hable R, Dimitrov D, et al. Minimal clinically important differences in conservative treatment versus hip arthroscopy for femoroacetabular impingement syndrome: a frequentist meta-analysis of RCTs. Orthop Surg 2025; 17(9): 2514-28. doi: 10.1111/os.70097.
von Elm E, Altman D G, Egger M, Pocock S J, Gøtzsche P C, Vandenbroucke J P, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 2007; 370(9596): 1453-7. doi: 10.1016/S0140-6736(07)61602-X.
Christensen R, Ranstam J, Overgaard S, Wagner P. Guidelines for a structured manuscript: statistical methods and reporting in biomedical research journals. Acta Orthop 2023; 94: 243-9. doi: 10.2340/17453674.2023.11656.
Buerba R A, Dalton J, Sadhwani S, Schulz W, Atte A C, Vyas D. Hip arthroscopy utilization disparities and complications amongst ethnic groups. Inquiry 2024; 61: 00469580241282644. doi: 10.1177/00469580241282644.
Sieurin L, Josephson M, Vingård E. Positive and negative consequences of sick leave for the individual, with special focus on part-time sick leave. Scand J Public Health 2009; 37(1): 50-6. doi: 10.1177/1403494808097171.
Statistikmyndigheten SCB [Internet]. [cited 2026 Aug 1]. Inkomster för personer i Sverige. Available from: https://www.scb.se/hitta-statistik/sverige-i-siffror/utbildning-jobb-och-pengar/inkomster-for-personer/
Birkmeyer J D, Reames B N, McCulloch P, Carr A J, Campbell W B, Wennberg J E. Understanding regional variation in the use of surgery. Lancet 2013; 382(9898): 1121–9. doi: 10.1016/S0140-6736(13)61215-5.
Horner N, Chapman R S, Larson J, Hevesi M, Nho S J. Workers’ compensation patients undergoing hip arthroscopy for femoroacetabular impingement syndrome experience worse mid-term outcomes but similar return-to-work: a propensity-matched analysis at 5-year follow-up. Arthroscopy 2023; 39(11): 2293-9.e1. doi: 10.1016/j.arthro.2023.03.023.
Cohn M R, Wichman D M, Newhouse A C, Mehta N, Fu M C, Chahla J, et al. High rate of full duty return to work after hip arthroscopy for femoroacetabular impingement syndrome in workers who are not on workers’ compensation. Am J Sports Med. 2021; 49(3): 729-36. doi: 10.1177/0363546520985517.
Li Z I, Shankar D S, Garra S, Hughes A J, Triana J, Blaeser A M, et al. Return to work following hip arthroscopy for femoroacetabular impingement syndrome: a case series. Surgeries 2023; 4(3): 391-400. doi :10.3390/surgeries4030039.
Additional Files
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2026 Miriam G Wadström, Anders Stålman, Tobias Wörner, Frida Eek, Nils P Hailer, Jesper Kraus-Schmitz, Yasmin D Hailer
This work is licensed under a Creative Commons Attribution 4.0 International License.
PlumX (by Elsevier) is an altmetrics platform that tracks and visualizes the online attention, usage, captures, citations, and social media engagement.
