title: United States National Trends in Ankle Arthroscopy: Analysis of the National Survey of Ambulatory Surgery and National Hospital Discharge Survey.
abstract: BACKGROUND
  . Ankle arthroscopy is increasingly being utilized for disorders previously limited to management with open surgery. Despite uniformly good results and few complications, little is known regarding national trends in ankle arthroscopy. This study sought to investigate changes in the use of inpatient and ambulatory ankle arthroscopy in the United States.
  
  
  METHODS
  . The National Survey of Ambulatory Surgery and the National Hospital Discharge Survey were used to identify cases of ankle arthroscopy. The data were analyzed for trends in demographics, treatment, and use.
  
  
  RESULTS
  Between 1994 and 2006, the population-adjusted rate of ankle arthroscopy increased by 65% (4.9/100 000 capita to 8.1/100 000 capita). The rate of ambulatory procedures increased by 80%, whereas the rate of inpatient procedures decreased by 95%. Sex-adjusted rates increased by 90% for males and 32% for females. The largest increases in age-adjusted rates were among patients 35 to 54 years of age. The proportion of procedures performed in freestanding ambulatory facilities increased from 15% to 49%. Use of peripheral nerve blocks during ambulatory procedures increased from 6% to 26%. Private insurance was the largest compensator at all times, and the proportion of workers' compensation payments increased from 8% to 22% during the study period.
  
  
  CONCLUSIONS
  . Results from the most recently available Centers for Disease Control and Prevention data demonstrated that rates of ambulatory ankle arthroscopy increased, whereas rates of inpatient ankle arthroscopy decreased dramatically between 1994 and 2006. Understanding national practice patterns can aid policy makers and surgeons in allocating health care resources, so as to ensure quality patient care.
  
  
  METHODS
  N/A (descriptive epidemiology study).
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Best
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, University of Miami Miller School of Medicine, Miami, Florida l.buller@med.miami.edu.
authors.forename: Leonard T
authors.initials: LT
authors.lastname: Buller
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Miranda
mesh_terms: D000293:Adolescent; D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000639:trends*; D016512:Ankle Injuries / Q000453:epidemiology / Q000601:surgery*; D000843:Ankle Joint / Q000601:surgery*; D001182:Arthroscopy / Q000639:trends*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys / Q000379:methods*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: ambulatory surgery; anesthesia; ankle arthroscopy; epidemiology