EP9.18 Assessing the Learning Curve in Hip Arthroscopy: A Prospective Case Series Analysis of Operative Efficiency Over Time

Abstract Background Hip arthroscopy remains a technically demanding procedure with a substantial learning curve. Developing surgical proficiency through increased caseload is critical for optimizing efficiency and refining training programs. The purpose of this study was to evaluate a single surgeon’s initial learning curve of hip arthroscopy cases based on operative efficiency. Methods All hip arthroscopies performed by a single hip preservation fellowship-trained surgeon were included, beginning with the surgeon’s first case as an attending. Prospective data collection was performed including total operating time, traction time, time to perform femoroplasty, and time to perform capsular closure. A generalized linear model using gamma distribution was employed due to the non-normal distribution of data. Regression analysis was used to determine changes in procedural times per case, and p-values were calculated to assess statistical significance, with a threshold of p < 0.05 indicating statistical significance. Results A total of 74 hip arthroscopy procedures were included, performed from October 2024 to February 2026. Mean operating time was 184 ± 71 minutes, mean traction time was 97 ± 54 minutes, mean femoroplasty time was 48 ± 21 minutes, and mean capsular closure time was 19 ± 11 minutes. Per doubling of case volume, there was an 8.1% (p < 0.013) decrease in total operating time, a 10.7% (p = 0.019) reduction in total traction time, a 1.6% (p = 0.68) reduction in femoroplasty time, and a 14.4% (p < 0.001) reduction in capsular closure time per case. The statistically significant measures displayed noticeable initial decreases and plateaued around 26 cases, whereas femoroplasty time remained mostly constant. Discussion During the initial hip arthroscopy learning curve, there is improved operative efficiency over time with regard to most aspects of the procedure with a statistically significant reduction in total operating time, traction time, and capsular closure time. Although the small sample size of this study limits definitive conclusions, these early trends underscore the importance of experience in enhancing procedural efficiency and support the use of operative metrics in surgical training programs.