Purpose
To determine whether (1) patient-reported outcome (PRO) scores after index hip arthroscopy
correlate with PRO scores for the contralateral hip in patients undergoing staged
bilateral hip arthroscopy and (2) patients who achieved minimal clinically important
difference (MCID) or patient-acceptable symptom state (PASS) for the index hip were
more likely to achieve MCID or PASS for the contralateral hip.
Methods
Patients who underwent staged bilateral hip arthroscopy for femoroacetabular impingement
syndrome were retrospectively reviewed. PRO scores were prospectively collected at
preoperative and 1- and 2-year timepoints. Odds ratios for achievement of MCID and
PASS for the contralateral hip given achievement for the index hip were calculated.
Improvements from before surgery to 2 years after surgery were correlated between
both hips.
Results
A total of 143 patients (286 hips) were included in the final analysis. Average time
between surgeries was 8.5 months (range, 0.7-57.2). Both hips demonstrated significant
improvement (P < .05 for all) in all PROs at 2 years. Achievement of MCID in Hip Outcome Score Activities
of Daily Living (HOS-ADL) at the 1-year timepoint for the index hip was predictive
of achievement of MCID in HOS-ADL at 2 years for the contralateral hip. Achievement
of PASS in all PROs at the 1-year timepoint for the index hip were predictive of achievement
of PASS in the equivalent outcome score at the 2-year mark for the contralateral hip.
Achievement of MCID or PASS at the 2-year timepoint for the index hip was predictive
of achievement of the equivalent outcome at the 2-year timepoint for the contralateral
hip. The strongest correlation between improvement in PRO scores for the index and
contralateral hips was noted in patients who underwent staged hip arthroscopy within
less than 3 months.
Conclusion
Patients experience significant clinical benefit in both hips after staged bilateral
hip arthroscopy. Results from the initial hip arthroscopy at either 1- or 2-year follow-up
can be used to predict outcomes on the contralateral side; however, there is a higher
degree of predictive value using 2-year results. Average correlations between 2-year
PROs on the index and contralateral hips were moderate to strong, regardless of the
time between surgeries.
Level of Evidence
Level III, retrospective cohort study.
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Article info
Publication history
Published online: December 07, 2022
Accepted:
October 12,
2022
Received:
February 1,
2022
Footnotes
See commentary on page 1183
The authors report the following potential conflicts of interest or sources of funding: S.J.N. reports personal fees from Ossur, Springer, and Stryker; non-financial support from Allosource, Arthrex, Inc., Athletico, DJ Orthopaedics, Linvatec, Miomed, and Smith & Nephew; and other from the American Orthopaedic Association, American Orthopaedic Society for Sports Medicine, and the Arthroscopy Association of North America. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2022 by the Arthroscopy Association of North America
