scholarly journals Anxiety and depression are associated with lower preoperative quality of life and function but not duration of symptoms in patients with femoroacetabular impingement syndrome

2019 ◽  
Author(s):  
Kate N Jochimsen ◽  
Justin A Magnuson ◽  
Kelsea R Kocan ◽  
Carl G Mattacola ◽  
Brian Noehren ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Impingement Syndrome ◽  
Anxiety And Depression ◽  
Duration Of Symptoms ◽  
Femoroacetabular Impingement Syndrome ◽  
And Function ◽  
Bony Morphology

Abstract The purposes of this study were to determine the prevalence of anxiety and depression in patients undergoing primary hip arthroscopy for femoroacetabular impingement syndrome (FAIS) and to compare duration of symptoms (DOS), hip morphology and self-reported pain and function between patients with and without anxiety or depression. From our Institutional Review Board approved registry, we identified 127 consecutive participants [94F/33M; age = 35.2 ± 12.1 years; body mass index (BMI) = 26.8 ± 5.6 kg/m2] scheduled for primary hip arthroscopy for FAIS. Anxiety and depression were recorded based on medical chart diagnoses or anti-depressive/anti-anxiety prescriptions. Alpha angle, lateral center edge angle and DOS were recorded, and the Hip Disability and Osteoarthritis Outcome Score (HOOS) was completed. Groups were compared using Mann–Whitney U tests, and categorical variables were compared using Fisher’s exact tests. Overall, 45 of 127 participants (35.4%) (94F/33M; age = 35.2 ± 12.1 years; BMI = 26.8 ± 5.6 kg/m2) had anxiety or depression. DOS and bony morphology did not differ between groups (P = 0.11–0.21). Participants with anxiety or depression were older (P = 0.03) and had worse HOOS QOL (21.4 ± 18.4; 30.7 ± 19.6; P = 0.006; 95% CI 2.4–16.3) and HOOS sport (25.6 ± 17.8, 34 ± 21.1, P = 0.03, 95% CI 1.4–15.4). More than one third of participants presented with anxiety or depression. Self-reported quality of life and function were worse for these participants, but neither symptom chronicity nor bony morphology differed. Concomitant anxiety or depression should be considered when counseling patients with FAIS. Adjunct interventions as well genetic and/or developmental factors that may contribute to the high prevalence should be examined.

Comparing Patient-Reported Outcome Measurements for Femoroacetabular Impingement Syndrome

2021 ◽  
pp. 036354652199940
Author(s):  
Nnaoma M. Oji ◽  
Hayley Jansson ◽  
Kendall E. Bradley ◽  
Brian T. Feeley ◽  
Alan L. Zhang
Keyword(s):  
Quality Of Life ◽  
Femoroacetabular Impingement ◽  
Patient Reported Outcome ◽  
Impingement Syndrome ◽  
Functional Activities ◽  
Outcome Score ◽  
Femoroacetabular Impingement Syndrome ◽  
Patient Reported ◽  
Pain Symptoms

Background: There is much debate in the current literature with regard to the most appropriate hip-specific patient-reported outcome (PRO) measurement for assessment of femoroacetabular impingement syndrome (FAIS) and outcomes after surgical treatment. Despite systematic reviews assessing the validity of classic hip-specific PROs as well as newer PROs developed to target the young, active population, there lacks a direct comparison of the question content between each PRO. Purpose: To compare the question composition and degree of overlap between commonly used PROs for FAIS. Study Design: Cross-sectional study Methods: A literature review yielded the 6 most commonly cited PROs for assessment of FAIS: modified Harris Hip Score (mHHS), Hip disability and Osteoarthritis Outcome Score (HOOS), Copenhagen Hip and Groin Outcome Score (HAGOS), Nonarthritic Hip Score (NAHS), international Hip Outcome Tool (iHOT-33), and Hip Outcome Score (HOS). Questions from each PRO were classified as identical, similar, or unique after pooled comparison, and the number of overlapping (identical or similar) questions between each PRO was determined. Questions were then classified into 5 domains: pain, symptoms, functional activities, sports, and quality of life, and variations in questions assessing each domain based on PRO were analyzed. Results: Analysis of 164 total questions from 6 PROs showed that 87 questions (53%) were identical between 2 or more PROs, 39 (24%) were similar, and 38 (23%) were unique. The iHOT-33 contained the highest number of unique questions, with 13 of 33 (39.4%), while the HOOS contained the lowest number of unique questions, with 3 of 40 (7.5%). The HOOS, HAGOS, and iHOT-33 contained questions assessing all 5 domains of patient outcomes; the NAHS did not evaluate quality of life; the mHHS only assessed pain, symptoms, and functional activities; and the HOS only assessed functional activities and sports. Conclusion: As there is a high percentage of overlapping (identical or similar) questions between the most commonly used hip-specific PROs for FAIS, multiple tests may be appropriate for use. The iHOT-33, HOOS, and HAGOS are well suited for the general population as they offer comprehensive assessments across all domains, while the HOS provides added focus to sports/activity assessments for athletes and highly active patients.

scholarly journals Clinically Significant Outcome Improvement After Hip Arthroscopy in Patients With Femoroacetabular Impingement Syndrome and Severe Femoral Torsion

2021 ◽  
Vol 9 (10) ◽  
pp. 232596712110345
Author(s):  
Steven F. DeFroda ◽  
Thomas D. Alter ◽  
Blake M. Bodendorfer ◽  
Alexander C. Newhouse ◽  
Felipe S. Bessa ◽  
...  
Keyword(s):  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Impingement Syndrome ◽  
Harris Hip Score ◽  
Femoral Torsion ◽  
Outcome Score ◽  
Femoroacetabular Impingement Syndrome ◽  
Patient Reported ◽  
Outcome Improvement ◽  
Clinically Significant

Background: The influence of femoral torsion on clinically significant outcome improvement after hip arthroscopy for femoroacetabular impingement syndrome (FAIS) has not been well-studied. Purpose: To quantify femoral torsion in FAIS patients using magnetic resonance imaging (MRI) and explore the relationship between femoral torsion and clinically significant outcome improvement after hip arthroscopy. Study Design: Cohort study; Level of evidence, 3. Methods: Included were patients who underwent hip arthroscopy for FAIS between January 2012 and August 2018 and had 2-year follow-up and preoperative MRI scans containing transcondylar slices of the knee. Participants were categorized as having severe retrotorsion (SR; <0°), normal torsion (NT; 0°-25°), and severe antetorsion (SA; >25°) as measured on MRI. Patient-reported outcomes (PROs) included the Hip Outcome Score–Activities of Daily Living, Hip Outcome Score–Sports Subscale, modified Harris Hip Score, 12-item International Hip Outcome Tool (iHOT-12), and visual analog scale (VAS) for pain and satisfaction. Achievement of Patient Acceptable Symptom State (PASS) and substantial clinical benefit (SCB) were analyzed among cohorts. Results: Included were 183 patients (SR, n = 13; NT, n = 154; SA, n = 16) with a mean age, body mass index, and femoral torsion of 30.6 ± 12.1 years, 24.0 ± 4.4 kg/m2, and 12.55° ± 9.58°, respectively. The mean torsion was –4.5° ± 2.6° for the SR, 12.1° ± 6.8° for the NT, and 31.0° ± 3.6° for the SA group. There were between-group differences in the proportion of patients who achieved PASS and SCB on the iHOT-12, pain VAS, and any PRO ( P < .05). Post hoc analysis indicated that the SA group achieved lower rates of PASS and SCB on the iHOT-12 and pain VAS, and lower rates of PASS on any PRO versus the SR group ( P < .05); the SR group achieved higher rates of PASS and SCB on pain VAS scores versus the NT group ( P = .003). Conclusion: The orientation and severity of femoral torsion during hip arthroscopy influenced the propensity for clinically significant outcome improvement. Specifically, patients with femoral retrotorsion and femoral antetorsion had higher and lower rates of clinically significant outcome improvement, respectively.

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