Luca Pierannunzii1, Paolo Di Benedetto2, Christian Carulli3, Gennaro Fiorentino4, Daniele Munegato5, Manlio Panascì6, Domenico Potestio7, Filippo Randelli8, Federico Della Rocca9, Valentina Rosolen10, Manuela Giangreco10, Nicola Santori7. 1. 1 Gaetano Pini Orthopaedic Institute, Milan, Italy. 2. 2 Clinica Ortopedica, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy. 3. 3 Orthopaedic Clinic, University of Florence, Florence, Italy. 4. 4 Department of Orthopaedics and Traumatology, Humanitas Gavazzeni Hospital, Bergamo, Italy. 5. 5 Orthopaedic Department, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy. 6. 6 San Carlo di Nancy GVM Care and Research, Rome, Italy. 7. 7 Rome American Hospital, Rome, Italy. 8. 8 Hip Department and Trauma, IRCCS Policlinico San Donato, S. Donato Milanese, Milan, Italy. 9. 9 Hip Department I.R.C.C.S. Istituto Clinico Humanitas, Milan, Italy. 10. 10 Department of Medical Area, University of Udine, Udine, Italy.
Abstract
PURPOSE: To build a post-arthroscopy outcome-predictive score (POPS) associated with the likelihood of lasting benefit after arthroscopic treatment of femoroacetabular impingement (FAI) and based solely on unambiguous preoperative information. METHODS: A population of 220 FAI patients, operated on with standard techniques by orthopaedic surgeons trained in hip arthroscopy in 6 different centres, was evaluated physically or by telephone interview 2 to 5 years after surgery. The criteria of successful mid-term outcome (SMO) were agreed upon by all authors. A multivariate logistic regression, adjusted for patient's age and centre, was applied to predict SMO. In the model, the variables associated with the outcome were included and the relative ORs (odds ratios) were used to compute the FAI-POPS (FAI - post-arthroscopy outcome-predictive score). A ROC (receiver operating characteristic) curve was plotted and the optimum cut-off was calculated. RESULTS: 155 patients out of 220 showed a successful mid-term outcome. The optimum cut-off of FAI-POPS was calculated to be 6.3 and with this threshold it proved a sensitivity of 0.66 and a specificity of 0.69, a positive predictive value of 0.84 and a negative predictive value of 0.46. CONCLUSIONS: The standard arthroscopic treatment of FAI resulted in satisfactory persistent symptom relief for about 70% of patients. No or minimal osteoarthritis, short time elapsed from the appearance of symptoms and high preoperative modified Harris Hip Score are independent predictive factors of SMO. The FAI-POPS is obtained as sum of 3 odds ratios corresponding to the above prognostic factors and is a useful predictor of mid-term outcome after conventional arthroscopic FAI treatment.
PURPOSE: To build a post-arthroscopy outcome-predictive score (POPS) associated with the likelihood of lasting benefit after arthroscopic treatment of femoroacetabular impingement (FAI) and based solely on unambiguous preoperative information. METHODS: A population of 220 FAI patients, operated on with standard techniques by orthopaedic surgeons trained in hip arthroscopy in 6 different centres, was evaluated physically or by telephone interview 2 to 5 years after surgery. The criteria of successful mid-term outcome (SMO) were agreed upon by all authors. A multivariate logistic regression, adjusted for patient's age and centre, was applied to predict SMO. In the model, the variables associated with the outcome were included and the relative ORs (odds ratios) were used to compute the FAI-POPS (FAI - post-arthroscopy outcome-predictive score). A ROC (receiver operating characteristic) curve was plotted and the optimum cut-off was calculated. RESULTS: 155 patients out of 220 showed a successful mid-term outcome. The optimum cut-off of FAI-POPS was calculated to be 6.3 and with this threshold it proved a sensitivity of 0.66 and a specificity of 0.69, a positive predictive value of 0.84 and a negative predictive value of 0.46. CONCLUSIONS: The standard arthroscopic treatment of FAI resulted in satisfactory persistent symptom relief for about 70% of patients. No or minimal osteoarthritis, short time elapsed from the appearance of symptoms and high preoperative modified Harris Hip Score are independent predictive factors of SMO. The FAI-POPS is obtained as sum of 3 odds ratios corresponding to the above prognostic factors and is a useful predictor of mid-term outcome after conventional arthroscopic FAI treatment.
Entities:
Keywords:
Femoroacetabular impingement; hip arthroscopy; multivariate analysis; outcome; score
Authors: Tala Mujahed; Jeffrey D Hassebrock; Justin L Makovicka; Jordan R Pollock; Justin G Wilcox; Karan A Patel; Kostas J Economopoulos Journal: Orthop J Sports Med Date: 2021-11-29