Purpose
The purpose of the study was to analyze demographic, radiographic, and intraoperative
factors that influence the time to achieve the minimal clinically important difference
(MCID) and maximum outcome improvement satisfaction threshold (MOIT) after primary
hip arthroscopy for femoroacetabular impingement syndrome (FAIS) and labral tear.
Methods
Included patients had undergone hip arthroscopy with labral repair or reconstruction
for FAIS with labral tear between February 2008 and October 2018. Patients were excluded
if they had a prior ipsilateral hip surgery, prior hip conditions, a Tonnis grade
> 1, or were unwilling to participate. Multiple demographic, radiographic, and intraoperative
variables were collected. The modified Harris Hip Score (mHHS) and Non-Arthritic Hip
Score (NAHS) were collected before surgery and at 3 months, 1 year, and 2 years after
surgery. The MCID and MOIT for the mHHS and NAHS were either calculated or determined
through previously published values. A time-to-event analysis was performed to determine
variables predictive of early or delayed achievement of MCID or MOIT. Early achievement
was defined as achieving MCID or MOIT at the 3-month timepoint.
Results
Six hundred thirty-two hips (632 patients) were included. Of those that achieved MCID
and MOIT, 428 (73.0%) and 414 (73.0%) patients achieved MCID and 253 (47.9%) and 264
(52.5%) patients achieved MOIT by 3 months after surgery for mHHS and NAHS, respectively.
Younger age, capsular repair, and increasing alpha angle were associated with earlier
achievement for either MCID or MOIT. Increasing age, worker’s compensation claims,
and higher baseline patient-reported outcome measure scores were associated with delayed
achievement for either MCID or MOIT.
Conclusions
Most of the patients who achieved MCID and MOIT for mHHS and NAHS did so by 3 months
after surgery. Younger age, capsular repair, and increasing alpha angle were associated
with earlier achievement of MCID and MOIT after hip arthroscopy.
Level of Evidence
Level IV, case series.
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Article info
Publication history
Published online: December 14, 2021
Accepted:
December 1,
2021
Received:
April 19,
2021
Footnotes
The authors report the following potential conflicts of interest or sources of funding: A.C.L. reports grants from Arthrex and Stryker; personal fees from Arthrex and Graymount Medical; and non-financial support from Arthrex, Iroko, Medwest, Smith & Nephew, Stryker, Vericel, and Zimmer Biomet; he is the medical director of Hip Preservation at St. Alexius Medical Center and the clinical instructor at the University of Illinois College of Medicine. B.G.D. reports grants from the American Orthopedic Foundation, Arthrex, Kaufman Foundation, Medacta, Pacira Pharmaceuticals, Stryker, Breg, Mako Surgical Corp, Medwest Associates, ATI Physical Therapy, and St. Alexius Medical Center; other from the American Orthopedic Foundation, Pacira Pharmaceuticals, Stryker, Mako Surgical Corp, St. Alexius Medical Center, and Ossur; personal fees from Adventist Hinsdale Hospital, Amplitude, Medacta, Pacira Pharmaceuticals, Stryker, Orthomerica, Mako Surgical Corp, St. Alexius Medical Center, and Amplitude; non-financial support from Amplitude, Arthrex, DJO Global, Medacta, Pacira Pharmaceuticals, Stryker, Mako Surgical Corp, Medwest Associates, and St. Alexius Medical Center; he has patent 8920497—Method and instrumentation for acetabular labrum reconstruction with royalties paid to Arthrex, patent 8708941—Adjustable multi-component hip orthosis with royalties paid to Orthomerica and DJO Global, and patent 9737292—Knotless suture anchors and methods of tissue repair with royalties paid to Arthrex; and is the medical director of Hip Preservation at St. Alexius Medical Center, the clinical instructor at the University of Illinois College Medicine, a board member for the American Hip Institute Research Foundation, AANA Learning Center Committee, the Journal of Hip Preservation Surgery, the Journal of Arthroscopy; and has had ownership interests in the American Hip Institute, Hinsdale Orthopedic Associates, Hinsdale Orthopedic Associates, Hinsdale Orthopedic Imaging, SCD#3 North Shore Surgical Suites, and Munster Specialty Surgery Center. D.R.M. reports non-financial support from Arthrex, Smith & Nephew, and Ossur; he is an editorial board member of the Journal of Arthroscopy. 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
