Advertisement

Patient Satisfaction Reporting for the Treatment of Femoroacetabular Impingement

      Purpose

      The purpose of this study was to evaluate how patient satisfaction after surgical femoroacetabular impingement (FAI) treatment is measured and reported in the current evidence base.

      Methods

      A review of the MEDLINE database was performed. Clinical outcome studies of FAI that reported a measure of patient satisfaction were included. Patient demographics, clinical outcome scores, and patient satisfaction measures were extracted. The NewCastle Ottawa Scale (NOS) was used to grade quality. Statistical analysis was primarily descriptive.

      Results

      Twenty-six studies met inclusion criteria; the mean NOS score among included studies was 5.7. Most studies were level 3 or 4 (n = 25, 96.1%). A 0 to 10 numeric scale, described by some studies as a visual analog scale, was the most commonly used method to assess satisfaction (n = 21; 80.8%), and mean reported scores ranged from 6.8 to 9.2 out of 10. Four studies (15.4%) used an ordinal scale, and 1 study (3.8%) used willingness to undergo surgery again as the measure of satisfaction. None of the included studies assessed preoperative satisfaction or patient expectation. Pooled cohort analysis was limited by significant overlapping study populations. Predictors of patients' satisfaction identified in included studies were presence of arthritis and postoperative outcome scores.

      Conclusions

      Patient satisfaction was not uniformly assessed in the literature. Most studies used a 0- to 10-point satisfaction scale, but none distinguished between the process of care and the outcome of care. Although satisfaction scores were generally high, the quality of the methodologies in the studies that reported satisfaction was low, and the studies likely included overlapping patient populations. More work needs to be done to develop standardized ways for assessing patient satisfaction after arthroscopic hip surgery and other procedures in orthopaedic sports medicine.

      Level of Evidence

      Level III, systematic review of Level III studies.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Arthroscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Leunig M.
        • Beaule P.E.
        • Ganz R.
        The concept of femoroacetabular impingement: Current status and future perspectives.
        Clin Orthop Relat Res. 2009; 467: 616-622
        • McCarthy J.
        • McMillan S.
        Arthroscopy of the hip: Factors affecting outcome.
        Orthop Clin North Am. 2013; 44: 489-498
        • Montgomery S.R.
        • Ngo S.S.
        • Hobson T.
        • et al.
        Trends and demographics in hip arthroscopy in the United States.
        Arthroscopy. 2013; 29: 661-665
        • Bozic K.J.
        • Chan V.
        • Valone 3rd, F.H.
        • Feeley B.T.
        • Vail T.P.
        Trends in hip arthroscopy utilization in the United States.
        J Arthroplasty. 2013; 28: 140-143
        • Harris-Hayes M.
        • McDonough C.M.
        • Leunig M.
        • Lee C.B.
        • Callaghan J.J.
        • Roos E.M.
        Clinical outcomes assessment in clinical trials to assess treatment of femoroacetabular impingement: Use of patient-reported outcome measures.
        J Am Acad Orthop Surg. 2013; 21: S39-S46
        • Graham B.
        • Green A.
        • James M.
        • Katz J.
        • Swiontkowski M.
        Measuring patient satisfaction in orthopaedic surgery.
        J Bone Joint Surg Am. 2015; 97: 80-84
        • Nwachukwu B.U.
        • Schairer W.W.
        • Bernstein J.L.
        • Dodwell E.R.
        • Marx R.G.
        • Allen A.A.
        Cost-effectiveness analyses in orthopaedic sports medicine: A systematic review.
        Am J Sports Med. 2015; 43: 1530-1537
        • Hamid K.S.
        • Nwachukwu B.U.
        • Poehling G.G.
        Lights, camera, action: How to make arthroscopy a star in value-based health care.
        Arthroscopy. 2013; 29: 1900-1901
        • Foster T.E.
        Redefining the value of sports medicine.
        Am J Sports Med. 2015; 43: 1573-1574
        • Nwachukwu B.U.
        • Rebolledo B.J.
        • McCormick F.
        • Rosas S.
        • Harris J.D.
        • Kelly B.T.
        Arthroscopic versus open treatment of femoroacetabular impingement: A systematic review of medium- to long-term outcomes.
        Am J Sports Med. 2016; 44: 1062-1068
        • Philippon M.J.
        • Briggs K.K.
        • Yen Y.M.
        • Kuppersmith D.A.
        Outcomes following hip arthroscopy for femoroacetabular impingement with associated chondrolabral dysfunction: Minimum two-year follow-up.
        J Bone Joint Surg Br. 2009; 91: 16-23
        • Larson C.M.
        • Giveans M.R.
        Arthroscopic management of femoroacetabular impingement: Early outcomes measures.
        Arthroscopy. 2008; 24: 540-546
        • Stevens M.S.
        • Legay D.A.
        • Glazebrook M.A.
        • Amirault D.
        The evidence for hip arthroscopy: Grading the current indications.
        Arthroscopy. 2010; 26: 1370-1383
        • Sansone M.
        • Ahldén M.
        • Jonasson P.
        • et al.
        Outcome of hip arthroscopy in patients with mild to moderate osteoarthritis-a prospective study.
        J Hip Preserv Surg. 2015; 3: 61-67
        • Moher D.
        • Cook D.J.
        • Eastwood S.
        • Olkin I.
        • Rennie D.
        • Stroup D.F.
        Improving the quality of reports of meta-analyses of randomised controlled trials: The QUOROM statement. Quality of reporting of meta-analyses.
        Lancet. 1999; 354: 1896-1900
        • Moher D.
        • Liberati A.
        • Tetzlaff J.
        • Altman D.G.
        • Group P
        Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement.
        J Clin Epidemiol. 2009; 62: 1006-1012
        • Knies S.
        • Evers S.M.
        • Candel M.J.
        • Severens J.L.
        • Ament A.J.
        Utilities of the EQ-5D: Transferable or not?.
        PharmacoEconomics. 2009; 27: 767-779
        • Johnson J.A.
        • Luo N.
        • Shaw J.W.
        • Kind P.
        • Coons S.J.
        Valuations of EQ-5D health states: Are the United States and United Kingdom different?.
        Med Care. 2005; 43: 221-228
        • Prather H.
        • Hunt D.
        • Fournie A.
        • Clohisy J.C.
        Early intra-articular hip disease presenting with posterior pelvic and groin pain.
        PMR. 2009; 1: 809-815
        • Hunt D.
        • Prather H.
        • Harris Hayes M.
        • Clohisy J.C.
        Clinical outcomes analysis of conservative and surgical treatment of patients with clinical indications of prearthritic, intra-articular hip disorders.
        PMR. 2012; 4: 479-487
        • Domb B.G.
        • Stake C.E.
        • Lindner D.
        • El-Bitar Y.
        • Jackson T.J.
        Arthroscopic capsular plication and labral preservation in borderline hip dysplasia: Two-year clinical outcomes of a surgical approach to a challenging problem.
        Am J Sports Med. 2013; 41: 2591-2598
        • Matsuda D.K.
        • Ribas M.
        • Matsuda N.A.
        • Domb B.G.
        Multicenter outcomes of endoscopic pubic symphysectomy for osteitis pubis associated with femoroacetabular impingement.
        Arthroscopy. 2015; 31: 1255-1260
        • El Bitar Y.F.
        • Stake C.E.
        • Dunne K.F.
        • Botser I.B.
        • Domb B.G.
        Arthroscopic iliopsoas fractional lengthening for internal snapping of the hip: Clinical outcomes with a minimum 2-year follow-up.
        Am J Sports Med. 2014; 42: 1696-1703
        • Domb B.G.
        • El Bitar Y.F.
        • Lindner D.
        • Jackson T.J.
        • Stake C.E.
        Arthroscopic hip surgery with a microfracture procedure of the hip: Clinical outcomes with two-year follow-up.
        Hip Int. 2014; 24: 448-456
        • Stake C.E.
        • Jackson T.J.
        • Stone J.C.
        • Domb B.G.
        Hip arthroscopy for labral tears in workers' compensation: A matched-pair controlled study.
        Am J Sports Med. 2013; 41: 2302-2307
        • Sawyer G.A.
        • Briggs K.K.
        • Dornan G.J.
        • Ommen N.D.
        • Philippon M.J.
        Clinical outcomes after arthroscopic hip labral repair using looped versus pierced suture techniques.
        Am J Sports Med. 2015; 43: 1683-1688
        • Redmond J.M.
        • Gupta A.
        • Cregar W.M.
        • Hammarstedt J.E.
        • Gui C.
        • Domb B.G.
        Arthroscopic treatment of labral tears in patients aged 60 years or older.
        Arthroscopy. 2015; 31: 1921-1927
        • Potter B.K.
        • Freedman B.A.
        • Andersen R.C.
        • Bojescul J.A.
        • Kuklo T.R.
        • Murphy K.P.
        Correlation of Short Form-36 and disability status with outcomes of arthroscopic acetabular labral debridement.
        Am J Sports Med. 2005; 33: 864-870
        • Philippon M.J.
        • Yen Y.M.
        • Briggs K.K.
        • Kuppersmith D.A.
        • Maxwell R.B.
        Early outcomes after hip arthroscopy for femoroacetabular impingement in the athletic adolescent patient: A preliminary report.
        J Pediatr Orthop. 2008; 28: 705-710
        • Philippon M.J.
        • Weiss D.R.
        • Kuppersmith D.A.
        • Briggs K.K.
        • Hay C.J.
        Arthroscopic labral repair and treatment of femoroacetabular impingement in professional hockey players.
        Am J Sports Med. 2010; 38: 99-104
        • Philippon M.J.
        • Schroder E.S.B.G.
        • Briggs K.K.
        Hip arthroscopy for femoroacetabular impingement in patients aged 50 years or older.
        Arthroscopy. 2012; 28: 59-65
        • Philippon M.J.
        • Ejnisman L.
        • Ellis H.B.
        • Briggs K.K.
        Outcomes 2 to 5 years following hip arthroscopy for femoroacetabular impingement in the patient aged 11 to 16 years.
        Arthroscopy. 2012; 28: 1255-1261
        • Philippon M.J.
        • Briggs K.K.
        • Hay C.J.
        • Kuppersmith D.A.
        • Dewing C.B.
        • Huang M.J.
        Arthroscopic labral reconstruction in the hip using iliotibial band autograft: Technique and early outcomes.
        Arthroscopy. 2010; 26: 750-756
        • Palmer D.H.
        • Ganesh V.
        • Comfort T.
        • Tatman P.
        Midterm outcomes in patients with cam femoroacetabular impingement treated arthroscopically.
        Arthroscopy. 2012; 28: 1671-1681
        • Meftah M.
        • Rodriguez J.A.
        • Panagopoulos G.
        • Alexiades M.M.
        Long-term results of arthroscopic labral debridement: Predictors of outcomes.
        Orthopedics. 2011; 34: e588-e592
        • McCormick F.
        • Nwachukwu B.U.
        • Alpaugh K.
        • Martin S.D.
        Predictors of hip arthroscopy outcomes for labral tears at minimum 2-year follow-up: The influence of age and arthritis.
        Arthroscopy. 2012; 28: 1359-1364
        • Matsuda D.K.
        • Burchette R.J.
        Arthroscopic hip labral reconstruction with a gracilis autograft versus labral refixation: 2-year minimum outcomes.
        Am J Sports Med. 2013; 41: 980-987
        • Jackson T.J.
        • Hanypsiak B.
        • Stake C.E.
        • Lindner D.
        • El Bitar Y.F.
        • Domb B.G.
        Arthroscopic labral base repair in the hip: Clinical results of a described technique.
        Arthroscopy. 2014; 30: 208-213
        • Jackson T.J.
        • Hammarstedt J.E.
        • Vemula S.P.
        • Domb B.G.
        Acetabular labral base repair versus circumferential suture repair: A matched-paired comparison of clinical outcomes.
        Arthroscopy. 2015; 31: 1716-1721
        • Gupta A.
        • Redmond J.M.
        • Stake C.E.
        • Dunne K.F.
        • Domb B.G.
        Does primary hip arthroscopy result in improved clinical outcomes? 2-year clinical follow-up on a mixed group of 738 consecutive primary hip arthroscopies performed at a high-volume referral center.
        Am J Sports Med. 2016; 44: 74-82
        • Gupta A.
        • Redmond J.M.
        • Hammarstedt J.E.
        • Stake C.E.
        • Domb B.G.
        Does obesity affect outcomes in hip arthroscopy? A matched-pair controlled study with minimum 2-year follow-up.
        Am J Sports Med. 2015; 43: 965-971
        • Gupta A.
        • Redmond J.M.
        • Hammarstedt J.E.
        • Lindner D.
        • Stake C.E.
        • Domb B.G.
        Does obesity affect outcomes after hip arthroscopy? A cohort analysis.
        J Bone Joint Surg Am. 2015; 97: 16-23
        • Geyer M.R.
        • Philippon M.J.
        • Fagrelius T.S.
        • Briggs K.K.
        Acetabular labral reconstruction with an iliotibial band autograft: Outcome and survivorship analysis at minimum 3-year follow-up.
        Am J Sports Med. 2013; 41: 1750-1756
        • Frank R.M.
        • Lee S.
        • Bush-Joseph C.A.
        • Kelly B.T.
        • Salata M.J.
        • Nho S.J.
        Improved outcomes after hip arthroscopic surgery in patients undergoing T-capsulotomy with complete repair versus partial repair for femoroacetabular impingement: A comparative matched-pair analysis.
        Am J Sports Med. 2014; 42: 2634-2642
        • Domb B.G.
        • Stake C.E.
        • Botser I.B.
        • Jackson T.J.
        Surgical dislocation of the hip versus arthroscopic treatment of femoroacetabular impingement: A prospective matched-pair study with average 2-year follow-up.
        Arthroscopy. 2013; 29: 1506-1513
        • Domb B.G.
        • Redmond J.M.
        • Dunne K.F.
        • Stake C.E.
        • Gupta A.
        A matched-pair controlled study of microfracture of the hip with average 2-year follow-up: Do full-thickness chondral defects portend an inferior prognosis in hip arthroscopy?.
        Arthroscopy. 2015; 31: 628-634
        • Domb B.G.
        • Linder D.
        • Finley Z.
        • et al.
        Outcomes of hip arthroscopy in patients aged 50 years or older compared with a matched-pair control of patients aged 30 years or younger.
        Arthroscopy. 2015; 31: 231-238
        • Domb B.G.
        • Gupta A.
        • Dunne K.F.
        • Gui C.
        • Chandrasekaran S.
        • Lodhia P.
        Microfracture in the hip: Results of a matched-cohort controlled study with 2-year follow-up.
        Am J Sports Med. 2015; 43: 1865-1874
        • Boykin R.E.
        • Patterson D.
        • Briggs K.K.
        • Dee A.
        • Philippon M.J.
        Results of arthroscopic labral reconstruction of the hip in elite athletes.
        Am J Sports Med. 2013; 41: 2296-2301
        • Wells G.
        • Shea B.
        • O’connell D.
        • et al.
        The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses.
        Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, ON2000
        • Dodwell E.R.
        • Latorre J.G.
        • Parisini E.
        • et al.
        NSAID exposure and risk of nonunion: a meta-analysis of case-control and cohort studies.
        Calcif Tissue Int. 2010; 87: 193-202
        • Younger A.S.
        • Wing K.J.
        • Glazebrook M.
        • et al.
        Patient expectation and satisfaction as measures of operative outcome in end-stage ankle arthritis: A prospective cohort study of total ankle replacement versus ankle fusion.
        Foot Ankle Int. 2015; 36: 123-134
        • Scott C.E.
        • Bugler K.E.
        • Clement N.D.
        • MacDonald D.
        • Howie C.R.
        • Biant L.C.
        Patient expectations of arthroplasty of the hip and knee.
        J Bone Joint Surg Br. 2012; 94: 974-981
        • Bourne R.B.
        • Chesworth B.M.
        • Davis A.M.
        • Mahomed N.N.
        • Charron K.D.
        Patient satisfaction after total knee arthroplasty: Who is satisfied and who is not?.
        Clin Orthop Relat Res. 2010; 468: 57-63
        • Soroceanu A.
        • Ching A.
        • Abdu W.
        • McGuire K.
        Relationship between preoperative expectations, satisfaction, and functional outcomes in patients undergoing lumbar and cervical spine surgery: A multicenter study.
        Spine. 2012; 37: E103-E108