Dominic S Carreira1, Daniel B Shaw2, Andrew B Wolff3, John J Christoforetti4, John P Salvo5, Benjamin R Kivlan6, Dean K Matsuda7. 1. Peachtree Orthopedics, Atlanta, GA, USA. Carreira.research@gmail.com. 2. Peachtree Orthopedics, Atlanta, GA, USA. 3. Hip Preservation and Sports Medicine, Washington Orthopaedics and Sports Medicine, Washington, DC, USA. 4. Hip Preservation and Sports Medicine, Texas Health Physicians Group, Dallas, TX, USA. 5. Rothman Orthopaedic Institute, Philadelphia, PA, USA. 6. Duquesne University, Pittsburgh, PA, USA. 7. DISC Sports and Spine Center, Marina del Rey, CA, USA.
Abstract
INTRODUCTION: Studies have demonstrated a negative relationship between the length of time with symptoms and patient-reported outcome measures in primary hip arthroscopy. Our aim was to expand the generalizability of this finding with a multi-center cohort. METHODS: A multi-center hip arthroscopy registry was queried for patients undergoing primary hip arthroscopy from 2014 to 2017. Patients were stratified according to whether pre-operative symptom duration exceeded two years or did not exceed two years. A Wilcoxon rank sum test was performed for differences in two year post-operative outcome scores. Logistic regression models analyzed the influence of symptom duration on achieving clinically meaningful thresholds (minimum clinically important difference, patient-acceptable symptom state, substantial clinical benefit) when controlling for baseline scores, age, BMI, and sex. RESULTS: Seven hundred forty-four patients met the inclusion criteria, from which 620 had complete outcomes information. The mean ± SD 2-year iHOT-12 scores of patients with symptom duration greater than two years (69 ± 26) were significantly lower than patients with symptom duration less than two years (77 ± 23) (Dunn test, p < 0.001). Chronic duration of pain was a negative predictor of achieving iHOT-12 MCID (0.47 [0.31-0.72]), PASS (0.53 [0.37-0.76]), and SCB (0.67 [0.47-0.94]). CONCLUSION: When controlling for differences in baseline demographic factors and pre-operative iHOT-12 scores, patients with chronic pain report poorer functional outcomes at mid-term follow-up. These results suggest that chronic pain predicts inferior outcomes from primary hip arthroscopy and that surgical intervention at earlier time points may be beneficial in achieving better outcomes.
INTRODUCTION: Studies have demonstrated a negative relationship between the length of time with symptoms and patient-reported outcome measures in primary hip arthroscopy. Our aim was to expand the generalizability of this finding with a multi-center cohort. METHODS: A multi-center hip arthroscopy registry was queried for patients undergoing primary hip arthroscopy from 2014 to 2017. Patients were stratified according to whether pre-operative symptom duration exceeded two years or did not exceed two years. A Wilcoxon rank sum test was performed for differences in two year post-operative outcome scores. Logistic regression models analyzed the influence of symptom duration on achieving clinically meaningful thresholds (minimum clinically important difference, patient-acceptable symptom state, substantial clinical benefit) when controlling for baseline scores, age, BMI, and sex. RESULTS: Seven hundred forty-four patients met the inclusion criteria, from which 620 had complete outcomes information. The mean ± SD 2-year iHOT-12 scores of patients with symptom duration greater than two years (69 ± 26) were significantly lower than patients with symptom duration less than two years (77 ± 23) (Dunn test, p < 0.001). Chronic duration of pain was a negative predictor of achieving iHOT-12 MCID (0.47 [0.31-0.72]), PASS (0.53 [0.37-0.76]), and SCB (0.67 [0.47-0.94]). CONCLUSION: When controlling for differences in baseline demographic factors and pre-operative iHOT-12 scores, patients with chronic pain report poorer functional outcomes at mid-term follow-up. These results suggest that chronic pain predicts inferior outcomes from primary hip arthroscopy and that surgical intervention at earlier time points may be beneficial in achieving better outcomes.
Authors: Daniel W Griffin; Matthew J Kinnard; Peter M Formby; Michael P McCabe; Terrence D Anderson Journal: Am J Sports Med Date: 2016-10-18 Impact factor: 6.202
Authors: Bryce A Basques; Brian R Waterman; Gift Ukwuani; Edward C Beck; William H Neal; Nicole A Friel; Austin V Stone; Shane J Nho Journal: Am J Sports Med Date: 2018-11-28 Impact factor: 6.202
Authors: Kyle N Kunze; Benedict U Nwachukwu; Edward C Beck; Jorge Chahla; Anirudh K Gowd; Jonathan Rasio; Shane J Nho Journal: Arthroscopy Date: 2019-12-31 Impact factor: 4.772