EP2.22 Temporal trends and geographical variation of pelvic osteotomy in England from 2010 to 2023

Abstract

Introduction: Hip dysplasia in young adults can be treated by pelvic osteotomies (PO) techniques, including triple and periacetabular osteotomy, which preserve the native hip joint. Despite an increase in clinical interest globally, the trends, demographics and geographical variation of PO remain largely unknown. This study aimed to (1) analyse the temporal trends of PO, and (2) examine the geographical variation of PO across England from 2010 to 2023. Methods: We performed a retrospective review analysing national data from the Hospital Episode Statistics (HES) database in England. We identified all patients ages over 14 who underwent PO in NHS England hospitals between April 2010 and March 2023 using OPCS-4 codes: ‘X222+Z75ʹ. We collected patient demographics including age, sex and region of treatment. The primary outcome was the annual count of PO procedures. Descriptive analysis was performed using Excel and GraphPad Prism, with regional data adjusted for population size, to evaluate the temporal trends of PO utilisation by age and sex, at a national and regional level. Results: In total, 1,348 POs were identified from the HES database. The annual number of POs increased by 64% from 2010 to 2023. The mean LOS was 5.4±3.9 days. Females accounted for 90% of the patients and were older than males (mean age: 29.0±8.7 vs. 25.8±9.2 years). The mean age of both sexes did not change significantly over the study period. In 2022/23, 121 POs were performed, with only four of nine regions performing more than seven POs. The mean regional incidence of PO procedures was 0.43 per 100,000, ranging from 0.08 to 2.07 per 100,000. Conclusions: This is the first and largest study to evaluate current PO trends and geographical variation in England. We demonstrate a significant increase in PO volume since 2010, female predominance, and significant regional variation, likely influenced by patient travel and referral patterns. Given the relatively low volume and high procedural complexity of PO, specialised regional hubs could centralise expertise and streamline care. These insights could inform future healthcare planning and resource allocation to ensure equitable access to PO services, improved patient outcomes, and better training opportunities for residents.