Purpose
To determine whether early patient-reported outcome improvements in the 6 months after
surgery are predictive of achieving a patient acceptable symptomatic state (PASS)
at 2 years.
Methods
A prospectively collected database was retrospectively reviewed. Inclusion criteria
included patients ≥18 years of age, Tönnis grade 0 or 1 changes, radiographic imaging
consistent with femoroacetabular impingement or labral pathology, a primary diagnosis
of symptomatic femoroacetabular impingement for which they underwent primary hip arthroscopy,
and baseline, 6-month, and 2-year modified Harris Hip Score (mHHS) scores. Revision
cases were excluded. Receiver operating characteristic curve analysis was conducted
to determine whether 6-month change in mHHS was a predictor for achieving PASS at
2 years.
Results
There were 173 patients (mean age: 39.8, 61.8% female) included within the study.
Patients who do not achieve the minimal clinically important difference (MCID), defined
as a change of 8 points in mHHS, by 6 months (n = 21) tended to have significantly
lower mHHS scores at 1 year and 2 years compared with those who did (n = 152). Only
52% of patients who did not achieve MCID by 6 months achieved MCID by 2 years (vs
98% for those that did) and only 24% achieved PASS by 2 years (vs 88% that did). Using
the MCID as a cutoff for improvement in mHHS at 6 months results in a 96% sensitivity
but 47% specificity for predicting PASS achievement at 2 years. Using 24 points of
improvement in mHHS as a cutoff at 6 months improves sensitivity and specificity to
81% and 80%, respectively.
Conclusions
Early improvement in mHHS scores is associated with 2-year outcomes. Patients who
do not achieve MCID within 6 months of surgery have a high rate of not achieving PASS
at 2 years.
Level of Evidence
IV, case series study
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Article info
Publication history
Published online: March 31, 2021
Accepted:
March 17,
2021
Received:
August 2,
2020
See commentary on page 3088Footnotes
The authors report the following potential conflicts of interest or sources of funding: T.Y. reports personal fees from Arthrex, outside the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2021 by the Arthroscopy Association of North America
