Kyle N Kunze1, Benedict U Nwachukwu1, Edward C Beck1, Jorge Chahla1, Anirudh K Gowd2, Jonathan Rasio1, Shane J Nho3. 1. Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois. 2. Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina, U.S.A. 3. Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois. Electronic address: nho.research@rushortho.com.
Abstract
PURPOSE: To determine the effect of the preoperative duration of femoroacetabular impingement syndrome (FAIS)-associated symptoms on clinical outcomes at a minimum of 5 years after hip arthroscopy. METHODS: We identified FAIS patients who underwent primary hip arthroscopy between January 2012 and January 2014 with a minimum of 5 years' follow-up. Patient demographic characteristics and clinical outcomes, comprising the Hip Outcome Score-Activities of Daily Living (HOS-ADL), Hip Outcome Score-Sports Subscale (HOS-SS), modified Harris Hip Score (mHHS), pain score, and satisfaction score, were analyzed. The minimal clinically important difference, patient acceptable symptomatic state, and substantial clinical benefit were calculated. Patients were stratified based on the preoperative duration of symptoms: less than 2 years versus 2 years or longer. Multivariate regressions were constructed to determine the association between the preoperative symptom duration and clinical outcomes at 5 years after hip arthroscopy. RESULTS: A total of 310 patients were included with a mean age (±standard deviation) of 34.1 ± 11.9 years and body mass index of 25.3 ± 5.1. The study group showed statistically significant improvements in the HOS-ADL, HOS-SS, mHHS, pain score, and satisfaction score (P < .001 for all). A preoperative duration of symptoms of 2 or more years was an independent predictor of worse HOS-ADL, HOS-SS, mHHS, and pain score (P < .05 for all). Furthermore, a longer duration of symptoms was associated with a lower likelihood of achieving the minimal clinically important difference for the HOS-ADL (odds ratio [OR], 0.53; P = .037), HOS-SS (OR, 0.38; P = .003), and mHHS (OR, 0.43; P = .009); the patient acceptable symptomatic state for the HOS-SS (OR, 0.44; P = .006) and mHHS (OR, 0.46; P = .006) but not the HOS-ADL despite trending toward significance (OR, 0.59; P = .098); and substantial clinical benefit for the HOS-ADL (OR, 0.50; P = .011), HOS-SS (OR, 0.52; P = .020), and mHHS (OR, 0.47; P = .007). CONCLUSIONS: Patients with a preoperative duration of FAIS-associated symptoms of 2 or more years prior to hip arthroscopy experience inferior outcomes and a lower frequency of clinically significant outcome improvement than patients with a shorter duration of symptoms at medium-to long-term follow-up. LEVEL OF EVIDENCE: Level III, retrospective comparative trial.
PURPOSE: To determine the effect of the preoperative duration of femoroacetabular impingement syndrome (FAIS)-associated symptoms on clinical outcomes at a minimum of 5 years after hip arthroscopy. METHODS: We identified FAISpatients who underwent primary hip arthroscopy between January 2012 and January 2014 with a minimum of 5 years' follow-up. Patient demographic characteristics and clinical outcomes, comprising the Hip Outcome Score-Activities of Daily Living (HOS-ADL), Hip Outcome Score-Sports Subscale (HOS-SS), modified Harris Hip Score (mHHS), pain score, and satisfaction score, were analyzed. The minimal clinically important difference, patient acceptable symptomatic state, and substantial clinical benefit were calculated. Patients were stratified based on the preoperative duration of symptoms: less than 2 years versus 2 years or longer. Multivariate regressions were constructed to determine the association between the preoperative symptom duration and clinical outcomes at 5 years after hip arthroscopy. RESULTS: A total of 310 patients were included with a mean age (±standard deviation) of 34.1 ± 11.9 years and body mass index of 25.3 ± 5.1. The study group showed statistically significant improvements in the HOS-ADL, HOS-SS, mHHS, pain score, and satisfaction score (P < .001 for all). A preoperative duration of symptoms of 2 or more years was an independent predictor of worse HOS-ADL, HOS-SS, mHHS, and pain score (P < .05 for all). Furthermore, a longer duration of symptoms was associated with a lower likelihood of achieving the minimal clinically important difference for the HOS-ADL (odds ratio [OR], 0.53; P = .037), HOS-SS (OR, 0.38; P = .003), and mHHS (OR, 0.43; P = .009); the patient acceptable symptomatic state for the HOS-SS (OR, 0.44; P = .006) and mHHS (OR, 0.46; P = .006) but not the HOS-ADL despite trending toward significance (OR, 0.59; P = .098); and substantial clinical benefit for the HOS-ADL (OR, 0.50; P = .011), HOS-SS (OR, 0.52; P = .020), and mHHS (OR, 0.47; P = .007). CONCLUSIONS:Patients with a preoperative duration of FAIS-associated symptoms of 2 or more years prior to hip arthroscopy experience inferior outcomes and a lower frequency of clinically significant outcome improvement than patients with a shorter duration of symptoms at medium-to long-term follow-up. LEVEL OF EVIDENCE: Level III, retrospective comparative trial.
Authors: Dominic S Carreira; Daniel B Shaw; Andrew B Wolff; John J Christoforetti; John P Salvo; Benjamin R Kivlan; Dean K Matsuda Journal: Int Orthop Date: 2022-09-10 Impact factor: 3.479
Authors: Sebastian Serong; Moritz Schutzbach; Stefan Fickert; Philipp Niemeyer; Christian Sobau; Gunther Spahn; Wolfgang Zinser; Stefan Landgraeber Journal: J Orthop Traumatol Date: 2021-08-04