Purpose
To determine the correlation between different patient-reported outcome (PRO) measurements
used to assess outcomes after arthroscopic treatment of femoroacetabular impingement
syndrome (FAIS) in a single cohort of patients.
Methods
Patients undergoing primary hip arthroscopy for FAIS (without dysplasia, arthritis,
or joint hypermobility) were retrospectively analyzed from a prospectively collected
cohort. PROs collected before surgery and at 2-year follow-up included the Visual
Analog Scale (VAS) for pain, modified Harris Hip Score (mHHS), Hip Disability and
Osteoarthritis Outcome Scores (HOOS) with subscales for symptoms, pain, activities
of daily living (ADL), sport, and quality of life (QoL), and the physical and mental
components of the Short Form-12 (SF-12 PCS and SF-12 MCS).
Results
Three hundred patients with 2 years’ follow-up (mean age 35.1 ± 11.3, BMI 24.7 ± 3.8,
52.7% female, median Tönnis grade 1) were identified. All patients underwent femoroplasty
and labral repair. There was a strong correlation among nearly all the PRO surveys
at 2-year follow-up, with the highest correlations identified between mHHS and HOOS-Pain
(r = .86, P < .001) and mHHS and HOOS-ADL (r = .85, P < .001). Preoperative scores and the change from preoperative to postoperative scores
demonstrated an overall moderate correlation between surveys. There was a consistently
weak correlation between the SF-12 MCS and all other PROs. There were strong agreements
(67%-77%) in the patients achieving minimal clinically important differences (MCID)
for each PRO survey. All surveys except the SF-12 demonstrated a ceiling effect after
surgery, with 13% to 43% of patients achieving the maximum score.
Conclusions
PRO surveys used for FAIS demonstrate strong correlations, especially in the evaluation
of patients during the postoperative period. MCID for VAS, mHHS, and HOOS demonstrate
strong agreement, whereas large ceiling effects were seen with the mHHS and HOOS.
The results support a more efficient use of PRO scores while being able to accurately
capture patient outcomes.
Level of Evidence
IV, retrospective case series.
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References
- The physician quality reporting initiative—A gateway to pay for performance: What every health care professional should know.Qual Manag Health Care. 2008; 17: 2-8
- Evidence-based orthopaedic surgery: What is evidence without the outcomes?.J Am Acad Orthop Surg. 2008; 16: 123-129
- Certification examinations part II: Patient reported outcomes.https://www.abos.org/certification/part-ii/patient-reported-outcomes/Date accessed: August 5, 2021
- High Degree of variability in reporting of clinical and patient-reported outcomes after hip arthroscopy.Am J Sports Med. 2018; 46: 3040-3046
- The top 50 most influential articles in hip arthroscopy.Arthroscopy. 2020; 36: 716-722
- International trends in arthroscopic hip preservation surgery-are we treating the same patient?.J Hip Preserv Surg. 2015; 2: 28-41
- Patient-reported outcomes in athletes following hip arthroscopy for femoroacetabular impingement with subanalysis on return to sport and performance level: A systematic review.Arthroscopy. 2021; 37: 2657-2676
- Hip arthroscopy outcomes with respect to patient acceptable symptomatic state and minimal clinically important difference.Arthroscopy. 2016; 32: 1877-1886
- Factors influencing healthcare provider respondent fatigue answering a globally administered in-app survey.PeerJ. 2017; 5: e3785
- Respondent fatigue.in: Lavrakas P.J. Encyclopedia of survey research methods. Sage Publications, Thousand Oaks, CA2008: 742-743 (2)
- Comparing patient-reported outcome measurements for femoroacetabular impingement syndrome.Am J Sports Med. 2021; 49: 1578-1588
- Relationship between iHOT12 and HOS scores in hip pain patients.J Hip Preserv Surg. 2021; 7: 57-61
- Periportal capsulotomy: Technique and outcomes for a limited capsulotomy during hip arthroscopy.Arthroscopy. 2019; 35: 1120-1127
- When do patients improve after hip arthroscopy for femoroacetabular impingement? A prospective cohort analysis.Am J Sports Med. 2018; 46: 3111-3118
- Interpretation of changes in health-related quality of life: The remarkable universality of half a standard deviation.Med Care. 2003; 41: 582-592
- Defining the clinically meaningful outcomes for arthroscopic treatment of femoroacetabular impingement syndrome at minimum 5-year follow-up.Am J Sports Med. 2020; 48: 901-907
- How can we define clinically important improvement in pain scores after hip arthroscopy for femoroacetabular impingement syndrome? Minimum 2-year follow-up study.Am J Sports Med. 2019; 47: 3133-3140
- Statistics corner: A guide to appropriate use of correlation coefficient in medical research.Malawi Med J. 2012; 24: 69-71
- Quality criteria were proposed for measurement properties of health status questionnaires.J Clin Epidemiol. 2007; 60: 34-42
- Patient-reported outcome measures for hip preservation surgery—A systematic review of the literature.J Hip Preserv Surg. 2015; 2: 15-27
- Defining the minimal clinically important difference in athletes undergoing arthroscopic correction of sports-related femoroacetabular impingement: The percentage of possible improvement.Orthop J Sports Med. 2020; 8 (2325967119894747)
- Arthroscopic treatment of femoroacetabular impingement in adolescents provides clinically significant outcome improvement.Arthroscopy. 2017; 33: 1812-1818
- The impact of mental health disorders on outcomes following hip arthroscopy for femoroacetabular impingement syndrome: A systematic review.J Hip Preserv Surg. 2020; 7: 195-204
- PROMIS Global-10 poorly correlates with legacy outcomes for patients undergoing hip arthroscopy.J Hip Preserv Surg. 2021; 8: 67-74
Article Info
Publication History
Published online: March 29, 2022
Accepted:
March 7,
2022
Received in revised form:
March 5,
2022
Received:
December 1,
2021
Publication stage
In Press Journal Pre-ProofFootnotes
The authors report the following potential conflict of interest or source of funding: A.L.Z. reports personal fees from Stryker and Depuy-Mitek. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2022 by the Arthroscopy Association of North America
