RobRoy L Martin1, Benjamin R Kivlan2, John J Christoforetti3, Andrew B Wolff4, Shane J Nho5, John P Salvo6, Thomas J Ellis7, Geoff Van Thiel8, Dean Matsuda9, Dominic S Carreira10. 1. Department of Physical Therapy, Rangos School of Health Sciences, Duquesne University, Pittsburgh, Pennsylvania, U.S.A.; Center for Sports Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, U.S.A.. Electronic address: martinr280@duq.edu. 2. Department of Physical Therapy, Rangos School of Health Sciences, Duquesne University, Pittsburgh, Pennsylvania, U.S.A. 3. Center for Athletic Hip Injury, Allegheny Health Network, Pittsburgh, Pennsylvania, U.S.A.; Department of Orthopaedic Surgery, Drexel University School of Medicine, Faculty-at-Large, American Hip Institute, Pittsburgh, Pennsylvania, U.S.A. 4. Hip Preservation and Sports Medicine, Washington Orthopaedics and Sports Medicine, Washington, D.C., U.S.A. 5. Division of Sports Medicine, Department of Orthopedic Surgery, Hip Preservation Center, Rush University Medical Center, Chicago, Illinois, U.S.A. 6. Orthopaedic Surgery, The Sydney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, U.S.A.; Hip Arthroscopy Program, Rothman Institute, Philadelphia, Pennsylvania, U.S.A. 7. Orthopedic One, Ohio Orthopedic Surgery Institute, Dublin Methodist Hospital, Columbus, Ohio, U.S.A. 8. OrthoIllinois, Chicago, Illinois, U.S.A.; Rush University Medical Center, Chicago, Illinois, U.S.A.; Chicago Blackhawks Medical Network, Chicago, Illinois, U.S.A. 9. DISC Sports and Spine Center, Marina del Rey, California, U.S.A. 10. Peachtree Orthopedics, Atlanta, Georgia, U.S.A.
Abstract
PURPOSE: To define minimal clinically important difference (MCID) and substantial clinical benefit (SCB) values for a pain visual analog scale (VAS) in patients undergoing hip arthroscopy for femoroacetabular impingement or chondrolabral pathology. METHODS: This was a retrospective review of prospective collected data on patients having hip arthroscopy for femoroacetabular impingement and/or chondrolabral pathology. On initial assessment and follow-up between 335 and 395 days postsurgery, subjects completed a pain VAS and categorical self-rating of function. MCID was calculated using one-half the standard deviation (SD) of the change in 1-year pain VAS values. Receiver operator characteristic analysis was performed to determine SCB values. A change in SCB value was determined based on change in categorical self-rating of function to create "improved" and "not improved" groups. Absolute postoperative SCB scores were calculated to determine scores that would be associated with "normal" or "abnormal" function ratings. RESULTS: Of 1,034 eligible patients, 733 (71%) met the inclusion criteria, with 537 (73%) women and 196 (27%) men having a mean age of 35.3 years (SD 13). At a mean of 352 (SD 21) days postsurgery, 536 (73%) were in the improved group and 197 (27%) in the not improved group. MCID was -15.0 mm. A change of -22.7 mm on the pain VAS was able to identify those that improved with high sensitivity (0.74) and specificity (0.63). Values of ≤10.4 mm and ≥29.0 mm were cutoffs identifying subjects that rated their function as normal or abnormal, respectively, with high sensitivity (0.79 and 0.76) and specificity (0.88 and 0.76). CONCLUSIONS: This study provides surgeons with information to help interpret pain VAS values at a follow-up period ranging from 335 to 395 days with MCID and SCB values of -15.0 mm and -22.7 mm, respectively. Additionally, a patient who assesses a pain level at ≤10.4 mm is likely to have a normal rating of function, whereas a patient who assesses a pain level at ≥29.0 mm is likely to have an abnormal rating of function. LEVEL OF EVIDENCE: III, retrospective comparative study.
PURPOSE: To define minimal clinically important difference (MCID) and substantial clinical benefit (SCB) values for a pain visual analog scale (VAS) in patients undergoing hip arthroscopy for femoroacetabular impingement or chondrolabral pathology. METHODS: This was a retrospective review of prospective collected data on patients having hip arthroscopy for femoroacetabular impingement and/or chondrolabral pathology. On initial assessment and follow-up between 335 and 395 days postsurgery, subjects completed a pain VAS and categorical self-rating of function. MCID was calculated using one-half the standard deviation (SD) of the change in 1-year pain VAS values. Receiver operator characteristic analysis was performed to determine SCB values. A change in SCB value was determined based on change in categorical self-rating of function to create "improved" and "not improved" groups. Absolute postoperative SCB scores were calculated to determine scores that would be associated with "normal" or "abnormal" function ratings. RESULTS: Of 1,034 eligible patients, 733 (71%) met the inclusion criteria, with 537 (73%) women and 196 (27%) men having a mean age of 35.3 years (SD 13). At a mean of 352 (SD 21) days postsurgery, 536 (73%) were in the improved group and 197 (27%) in the not improved group. MCID was -15.0 mm. A change of -22.7 mm on the pain VAS was able to identify those that improved with high sensitivity (0.74) and specificity (0.63). Values of ≤10.4 mm and ≥29.0 mm were cutoffs identifying subjects that rated their function as normal or abnormal, respectively, with high sensitivity (0.79 and 0.76) and specificity (0.88 and 0.76). CONCLUSIONS: This study provides surgeons with information to help interpret pain VAS values at a follow-up period ranging from 335 to 395 days with MCID and SCB values of -15.0 mm and -22.7 mm, respectively. Additionally, a patient who assesses a pain level at ≤10.4 mm is likely to have a normal rating of function, whereas a patient who assesses a pain level at ≥29.0 mm is likely to have an abnormal rating of function. LEVEL OF EVIDENCE: III, retrospective comparative study.
Authors: Ryan P McGovern; RobRoy L Martin; Amy L Phelps; Benjamin R Kivlan; Beth Nickel; John J Christoforetti Journal: J Hip Preserv Surg Date: 2020-01-22
Authors: Ian M Clapp; Benedict U Nwachukwu; Edward C Beck; Jonathan P Rasio; Thomas Alter; Bradley Allison; Shane J Nho Journal: Arthrosc Sports Med Rehabil Date: 2020-01-08