Jorge Chahla1, Edward C Beck1, Benedict U Nwachukwu1, Thomas Alter1, Joshua D Harris2, Shane J Nho3. 1. Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A. 2. Department of Orthopaedic Surgery, Houston Methodist Hospital, Houston, Texas, U.S.A. 3. Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.. Electronic address: nho.research@rushortho.com.
Abstract
PURPOSE: To determine the relationship between preoperative patient expectation and postoperative satisfaction and overall patient-reported outcome (PRO) of patients undergoing hip arthroscopy for femoroacetabular impingement syndrome. METHODS: Patients who underwent hip arthroscopy for femoroacetabular impingement syndrome completed the validated Hip Preservation Surgery Expectations Survey (21 questions; 0-100 range), as well as multiple PROs before surgery. High expectation was defined as an expectation score greater than 1 standard deviation above the mean. Patients with osteoarthritis, dysplasia, and those having undergone previous hip surgery were excluded. At 1 year postoperatively, patient visual analog scale (VAS) satisfaction, VAS pain, and PROs were assessed. Univariable and multivariate analyses were performed. RESULTS: One-hundred fifty-three subjects (mean age 34.4 ± 12.6 years, female: 114 [71.3%], body mass index: 25.9 ± 5.3 kg/m2) participated. The mean expectation score was 84.5 ± 12.3. Significant correlations between high expectation scores (>96.7) and achieving the minimal clinical important difference (MCID) for modified Harris Hip Score (mHHS; r = 0.339; P = .043) and patient acceptable symptomatic state (PASS) for Hip Outcome Score-Activities of Daily Living Subscale (HOS-ADL; r = 0.207; P = .032) were observed. There were no significant correlations between high expectation scores and preoperative or postoperative PROs or patient satisfaction scores. χ2 analysis demonstrated patients with greater expectations had increased rates of reaching MCID mHHS (92.3% vs 74.7%; P = .08), PASS mHHS (85.7% vs 69.7%; P = .046), and PASS HOS-ADL (93.8% vs 67.4%; P = .031). CONCLUSIONS: High preoperative expectation is associated with increased rates of MCID/PASS achievement on mHHS and increased rate of PASS achievement on HOS-ADL. Preoperative expectations did not have an impact on Hip Outcome Score-Sports Subscale; however, patients with high preoperative expectations also have a high baseline Hip Outcome Score-Sports Subscale. In addition, preoperative expectations are not associated with postoperative VAS satisfaction scores. LEVEL OF EVIDENCE: III; non-randomized cohort, therapeutic.
PURPOSE: To determine the relationship between preoperative patient expectation and postoperative satisfaction and overall patient-reported outcome (PRO) of patients undergoing hip arthroscopy for femoroacetabular impingement syndrome. METHODS:Patients who underwent hip arthroscopy for femoroacetabular impingement syndrome completed the validated Hip Preservation Surgery Expectations Survey (21 questions; 0-100 range), as well as multiple PROs before surgery. High expectation was defined as an expectation score greater than 1 standard deviation above the mean. Patients with osteoarthritis, dysplasia, and those having undergone previous hip surgery were excluded. At 1 year postoperatively, patient visual analog scale (VAS) satisfaction, VAS pain, and PROs were assessed. Univariable and multivariate analyses were performed. RESULTS: One-hundred fifty-three subjects (mean age 34.4 ± 12.6 years, female: 114 [71.3%], body mass index: 25.9 ± 5.3 kg/m2) participated. The mean expectation score was 84.5 ± 12.3. Significant correlations between high expectation scores (>96.7) and achieving the minimal clinical important difference (MCID) for modified Harris Hip Score (mHHS; r = 0.339; P = .043) and patient acceptable symptomatic state (PASS) for Hip Outcome Score-Activities of Daily Living Subscale (HOS-ADL; r = 0.207; P = .032) were observed. There were no significant correlations between high expectation scores and preoperative or postoperative PROs or patient satisfaction scores. χ2 analysis demonstrated patients with greater expectations had increased rates of reaching MCID mHHS (92.3% vs 74.7%; P = .08), PASS mHHS (85.7% vs 69.7%; P = .046), and PASS HOS-ADL (93.8% vs 67.4%; P = .031). CONCLUSIONS: High preoperative expectation is associated with increased rates of MCID/PASS achievement on mHHS and increased rate of PASS achievement on HOS-ADL. Preoperative expectations did not have an impact on Hip Outcome Score-Sports Subscale; however, patients with high preoperative expectations also have a high baseline Hip Outcome Score-Sports Subscale. In addition, preoperative expectations are not associated with postoperative VAS satisfaction scores. LEVEL OF EVIDENCE: III; non-randomized cohort, therapeutic.
Authors: Ida Lindman; Sarantos Nikou; Axel Öhlin; Eric Hamrin Senorski; Olufemi Ayeni; Jon Karlsson; Mikael Sansone Journal: J Exp Orthop Date: 2021-04-23