scholarly journals Patient-reported outcome score utilisation in arthroscopic hip preservation: we are all doing it differently, if at all

2020 ◽  
Vol 5 (4) ◽  
pp. 213-217
Author(s):  
Derek M Klavas ◽  
Neil Duplantier ◽  
Brayden Gerrie ◽  
Patrick C McCulloch ◽  
Shane J Nho ◽  
...  
Keyword(s):  
Hip Joint ◽  
General Health ◽  
Short Form ◽  
Patient Reported Outcome ◽  
Harris Hip Score ◽  
Cross Sectional Survey ◽  
Level Of Evidence ◽  
Outcome Score ◽  
Patient Reported ◽  
Outcome Scores

ObjectivesTo determine which outcome scores physicians are using in hip preservation surgery, as well as when they are administered, who administers them and on what platform.MethodsA cross-sectional survey was conducted to examine which patient-reported outcome (PRO) scores are being used by hip preservation surgeons, including hip joint–specific, lower extremity limb–specific, disease-specific, general health, quality of life, pain, activity, spine and psychiatric wellness scores. Descriptive statistics were calculated. Heterogeneity was assessed using I2 statistics.ResultsFifty-six surgeons responded (mean 169 arthroscopic, 65 open hip preservation surgeries per year; mean 13 years experience). 13% of surgeons did not collect any patient outcome scores. A total of 25 different PROs were reported. Of 13 possible hip joint–specific outcome scores, the modified Harris Hip Score was most frequently collected (46%), followed by International Hip Outcome Tool−12 (41%) and Hip Outcome Score (38%). There was considerable heterogeneity in hip joint–specific PROs (I2 86%). The Short Form−12 was the most common general health score (30%). Tegner and UCLA Activity scores were collected by 11% of participants. Fifty-nine per cent collected outcomes preoperatively, 45% at 3 months, 54% at 6 months, 61% at 1 year and 32% annually. Paper collection was the most common collection platform (46%), and a dedicated research assistant was most frequently the source of data collection (34%).ConclusionThis international survey demonstrates that although most hip preservation surgeons collect hip outcome scores, there is a large amount of heterogeneity in outcome scores used and method of collection. As hip preservation evidence continues to evolve, these results should emphasise the need for an initiative to standardise outcome score collection.Level of evidenceLevel V.

scholarly journals Development of the HOOSglobal to Assess Patient-Reported Outcomes in Patients Undergoing Hip Preservation Procedures

2018 ◽  
Vol 46 (4) ◽  
pp. 940-946 ◽  
Author(s):  
Cale A. Jacobs ◽  
Michael R. Peabody ◽  
Stephen T. Duncan ◽  
Ryan D. Muchow ◽  
Ryan M. Nunley ◽  
...  
Keyword(s):  
Los Angeles ◽  
Short Form ◽  
Periacetabular Osteotomy ◽  
Patient Reported Outcome ◽  
Harris Hip Score ◽  
Level Of Evidence ◽  
Patient Reported ◽  
Orthopaedic Community ◽  
Pro Tools ◽  
Modified Harris Hip Score

Background: The creation of a single patient-reported outcome (PRO) platform validated across hip preservation, osteoarthritis (OA), and total hip arthroplasty (THA) populations may reduce barriers and streamline the routine collection of PROs in clinical practice. As such, the purpose of this study was to determine if augmenting the Hip disability and Osteoarthritis Outcome Score–Joint Replacement (HOOS, JR) with additional HOOS questions would result in a PRO platform that could be used across a wider spectrum of hip patient populations. Hypothesis: The HOOS, JR would demonstrate a notable ceiling effect, but by augmenting the HOOS, JR with additional HOOS questions, a responsive PRO platform could be created. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Using preoperative and postoperative HOOS responses from a sample of 304 patients undergoing periacetabular osteotomy (PAO), additional items were identified to augment the HOOS, JR. The psychometric properties of a newly created PRO tool (HOOSglobal) were then compared with the HOOS, JR and other PRO instruments developed for patients with hip OA and/or undergoing THA. Results: By augmenting the HOOS, JR with 2 additional questions, the HOOSglobal was more responsive than all other included PRO tools and had significantly fewer maximum postoperative scores than the HOOS, JR ( P < .0001), HOOS–Physical Function Short form ( P < .0001), Western Ontario and McMaster Universities Osteoarthritis Index ( P = .02), University of California, Los Angeles activity scale ( P = .0002), and modified Harris Hip Score ( P = .04). The postoperative HOOSglobal score threshold associated with patients achieving the patient acceptable symptom state (PASS) was 62.5. Conclusion: The HOOSglobal is a valid and responsive PRO tool after PAO and may potentially provide the orthopaedic community with a PRO platform to be used across hip-related subspecialties. For patients undergoing PAO, a postoperative HOOSglobal score ≥62.5 was associated with patients achieving the PASS.

scholarly journals Is There a Gender Gap in Outcomes After Hip Arthroscopy for Femoroacetabular Impingement? Assessment of Clinically Meaningful Improvements in a Prospective Cohort

2020 ◽  
Vol 8 (7) ◽  
pp. 232596711990056
Author(s):  
Sergio E. Flores ◽  
Caitlin C. Chambers ◽  
Kristina R. Borak ◽  
Alan L. Zhang
Keyword(s):  
Femoroacetabular Impingement ◽  
Gender Gap ◽  
Hip Arthroscopy ◽  
Short Form ◽  
Patient Reported Outcome ◽  
Harris Hip Score ◽  
Age Group ◽  
Level Of Evidence ◽  
Patient Reported ◽  
Modified Harris Hip Score

Background: Although patients have experienced significant improvements after hip arthroscopy for femoroacetabular impingement (FAI), prior studies suggest that women have worse outcomes than men. These previous studies lack comparisons of patient-reported outcome (PRO) scores based on gender with respect to clinical significance measurements, including the minimal clinically important difference (MCID) and patient acceptable symptom state (PASS). Purpose: To evaluate outcomes after hip arthroscopy for FAI based on patient gender by prospectively assessing changes in PRO scores, MCID, and PASS. Study Design: Cohort study; Level of evidence, 2. Methods: Women and men undergoing hip arthroscopy for FAI were prospectively enrolled, and preoperative radiographic and intraoperative findings were collected. Patients completed the following PRO surveys before surgery and 2 years postoperatively: modified Harris Hip Score (mHHS), Hip disability and Osteoarthritis Outcome Score (HOOS), and 12-Item Short Form Health Survey. Mean scores and percentage of patients reaching MCID and PASS were analyzed. Results: A total of 131 hips were included (72 women, 59 men). Women had smaller preoperative alpha angles (59.1° vs 63.7°, respectively; P < .001) and lower acetabular cartilage injury grade (6.9% vs 22.0% with grade 4 injury, respectively; P = .013). Both women and men achieved equivalent significant improvements in PRO scores after surgery (scores increased 18.4 to 45.1 points for mHHS and HOOS). Women and men reached PASS for mHHS at similar rates (76.4% and 77.2%, respectively; P = .915). MCID was also achieved at similar rates between women and men for all scores (range, 61.4%-88.9%) except the activities of daily living subscale of the HOOS, in which a greater percentage of women reached MCID compared with men (79.2% vs 62.7%, respectively; P = .037). Additional stratification by age group using the median cohort age of 34 years showed no significant differences in PRO improvement based on age group for each gender. Conclusion: Women can achieve clinically meaningful improvements in PRO scores after hip arthroscopy for FAI. Compared with men, women demonstrated equivalent high rates of achieving MCID and PASS at 2 years after surgery.

scholarly journals Assessing the Attitudes, Awareness, and Behavioral Alterations of Patients Awaiting Total Hip Arthroplasty During the COVID-19 Crisis

2020 ◽  
Vol 11 ◽  
pp. 215145932096937
Author(s):  
Stephen Fahy ◽  
Joss Moore ◽  
Michael Kelly ◽  
Shane Irwin ◽  
Paddy Kenny
Keyword(s):  
Mental Health ◽  
Short Form ◽  
Hip Osteoarthritis ◽  
Surgical Care ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Harris Hip Score ◽  
Physical And Mental Health ◽  
Patient Reported ◽  
Hip Function

Background: COVID-19 has placed a huge burden on healthcare systems which has led to widespread cancellation elective surgical care. Ireland is recovering from the first wave of COVID-19 and as such the expeditious return of elective surgical care is important. This is the first study to examine the attitudes of patients to undergoing total joint arthroplasty during the COVID-19 crisis. Methods: A prospective qualitative study was undertaken in our institution during the week 13/05/2020-20/05/2020. 65 patients completed a questionnaire assessing attitudes, awareness, and behavioral changes associated with COVID-19, a Charlson Comorbidity Index, modified-Harris Hip Score, and a Short Form-12 score. Results: 86% of patients felt that they were at little to no risk of COVID-19 infection. The majority of patients were happy to proceed with surgery at the current level of COVID-19 related threat (86%). Patients with higher mHHS were more likely to postpone their operation than those with lower mHHS scores. Our cohort had low patient reported outcome measures in both mHHS and SF-12, indicating the significant burden of hip osteoarthritis on both physical and mental health. Conclusion: Patients reported a significant disease-related impairment of physical function and subsequent deterioration in mental health as a result of hip osteoarthritis. Patients with worse hip function, as measured by the mHHS are more willing to proceed with surgery than those with superior hip function. This offers a potential mechanism by which to triage patients once elective surgical pathways reopen in the coming months.

Clinical and Radiographic Predictors for Unsalvageable Labral Tear at the Time of Initial Hip Arthroscopic Management for Femoroacetabular Impingement

2019 ◽  
Vol 47 (9) ◽  
pp. 2029-2037 ◽  
Author(s):  
Hirotaka Nakashima ◽  
Manabu Tsukamoto ◽  
Yasuo Ohnishi ◽  
Hajime Utsunomiya ◽  
Shiho Kanezaki ◽  
...  
Keyword(s):  
Risk Factors ◽  
Patient Reported Outcome ◽  
Labral Tear ◽  
Harris Hip Score ◽  
Patient Reported ◽  
Outcome Scores ◽  
The Mean ◽  
Modified Harris Hip Score ◽  
Reconstruction Group

Background:The acetabular labrum plays important roles in proprioception, nociception, synovial fluid seal effect, and static and dynamic joint stability and as a shock absorber. Clinical and radiographic risk factors for unsalvageable labral tear in femoroacetabular impingement (FAI) are not well established.Purpose:To identify predictors of unsalvageable labral tear during initial hip arthroscopic management of FAI.Study Design:Case-control study; Level of evidence, 3.Methods:Patients were included who underwent primary hip arthroscopic treatment for FAI between March 2009 and March 2014. Patients were excluded who had <2-year follow-up, underwent bilateral surgery, or had a history of surgery, osteoarthritis (Tönnis grade 2 or 3), and other diagnoses, including lateral center-edge angle <25° diagnosed as developmental hip dysplasia. Patients were divided into 2 groups according to their labral condition: reconstruction and refixation. Unsalvageable labral tear was defined as any irreparable labral tear, including severe degenerative tear, frayed labrum, labral ossification, flattened labrum, and failed prior repair during surgery. Univariate and multivariate analyses identified risk factors for segmental labral reconstruction. Patient-reported outcome scores and postoperative revision rates were also assessed.Results:Twenty-five hips (18 male, 7 female) and 126 hips (65 male, 61 female) were included in the reconstruction and refixation groups, respectively. The mean ± SD ages were 52.6 ± 15.0 and 36.5 ± 16.1 years in the reconstruction and refixation groups, respectively. In the reconstruction group, the mean modified Harris Hip Score significantly improved from 67.3 ± 14.9 preoperatively to 95.0 ± 8.1 at final follow-up ( P < .001), and the mean Nonarthritic Hip Score improved from 63.0 ± 18.3 preoperatively to 89.5 ± 10.1 at final follow-up ( P < .001). In the refixation group, the mean modified Harris Hip Score significantly improved from 69.2 ± 18.6 preoperatively to 93.0 ± 11.2 at final follow-up ( P < .001), and the mean Nonarthritic Hip Score improved from 60.7 ± 18.8 preoperatively to 88.6 ± 15.0 at final follow-up ( P < .001). No significant difference was noted in patient-reported outcome scores and revision hip arthroscopy rates. The rate of conversion of total hip arthroplasty was higher in the reconstruction group than in the refixation group. Risk factors for unsalvageable labral tear were age ≥45 years (odds ratio [OR], 8.83; P < .007), body mass index ≥23.1 kg/m2(OR, 13.05; P < .001), and vertical center anterior angle ≥36° (OR, 19.03; P < .001). Furthermore, in this study, unsalvageable labral tears were present in cases with at least 2 of the 3 risk factors.Conclusion:Age ≥45 years, body mass index ≥23.1 kg/m2, and vertical center anterior angle ≥36° are risk factors for unsalvageable labral tear at initial hip arthroscopic surgery for patients with FAI.

Primary Circumferential Acetabular Labral Reconstruction: Achieving Outcomes Similar to Primary Labral Repair Despite More Challenging Patient Characteristics

2018 ◽  
Vol 46 (9) ◽  
pp. 2079-2088 ◽  
Author(s):  
John P. Scanaliato ◽  
Daniel L. Christensen ◽  
Catherine Salfiti ◽  
Mackenzie M. Herzog ◽  
Andrew B. Wolff
Keyword(s):  
Short Form ◽  
Primary Repair ◽  
High Stress ◽  
Labral Repair ◽  
Harris Hip Score ◽  
Iliotibial Band ◽  
Level Of Evidence ◽  
Visual Analog Scales ◽  
Patient Reported ◽  
Severe Pathology

Background: Treatment of acetabular labral tears with moderate or severe intrasubstance damage or segmental defects remains a substantial challenge. Circumferential labral reconstruction with iliotibial band allograft is a relatively new technique that has been proposed to restore stability and eliminate high-stress junction points. Purpose: To compare outcomes between hips treated with primary allograft circumferential labral reconstruction and primary labral repair. Study Design: Cohort study; Level of evidence, 3. Methods: All consecutive hips between 2014 and 2015 that underwent primary reconstruction or primary repair by the senior surgeon were included and compared. Hips that had a prior intra-articular procedure were excluded. Patient-reported outcome (PRO) scores and visual analog scales were completed by patients within 1 week before surgery and between 22 and 26 months postoperatively. PROs included the modified Harris Hip Score, the International Hip Outcome Tool, and the 12-Item Short Form Health Survey for physical health. Pain and satisfaction were assessed with visual analog scales. Crude and inverse probability of treatment weighting comparisons of PROs between groups were performed. Results: A total of 162 hips met the inclusion criteria for this study, including 99 labral repairs and 63 complete labral reconstructions. Patients who underwent labral reconstruction were, on average, older (43.4 vs 29.5 years; P < .01), had a slightly higher body mass index (24.6 vs 23.0; P < .01), had hips with a higher Tönnis grade (grade 1 or 2: 25% vs 9%; P < .01), had higher preoperative pain scores (49.9 vs 41.5; P = .01), and had hips with more severe pathology (68% vs 5%; P < .01) as compared with patients with labral repair hips. Five (5%) labral repair hips and 5 (8%) labral reconstruction hips failed treatment ( P = .48). Among hips that did not fail (n = 94 repairs, n = 58 reconstructions), all demonstrated statistically significant improvements in PROs, and there was no statistical difference in PROs between groups after weighting ( P > .05). Conclusion: Primary circumferential labral reconstruction is a viable treatment option with promising short-term outcomes for hips that demonstrate moderate or severe labral damage. Despite less favorable preoperative characteristics, labral reconstruction offers similar outcomes when compared with labral repair in hips with less severe pathology.

scholarly journals Preoperative Symptom Duration Is Associated With Outcomes After Hip Arthroscopy

2018 ◽  
Vol 47 (1) ◽  
pp. 131-137 ◽  
Author(s):  
Bryce A. Basques ◽  
Brian R. Waterman ◽  
Gift Ukwuani ◽  
Edward C. Beck ◽  
William H. Neal ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hip Arthroscopy ◽  
Patient Reported Outcomes ◽  
Harris Hip Score ◽  
Duration Of Symptoms ◽  
Outcome Score ◽  
Femoroacetabular Impingement Syndrome ◽  
Patient Reported ◽  
Outcome Scores

Background: Prolonged disease chronicity has been implicated as a cause of suboptimal clinical outcomes after hip arthroscopy for femoroacetabular impingement syndrome (FAIS), possibly due to disease progression, deconditioning, and the development of compensatory pathomechanics. Purpose: To evaluate the effect of increasing duration of preoperative symptoms on patient-reported outcomes, reoperation, and clinical failure of hip arthroscopy for FAIS. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective cohort study was performed to identify all patients undergoing primary hip arthroscopy between January 1, 2012, and July 30, 2014, by a single surgeon, with minimum follow-up of 2 years. Patient demographics, comorbid medical conditions, and preoperative outcome scores were compared between patients with preoperative symptoms lasting less than 2 years and those with symptoms lasting 2 years or longer. Multivariate regressions were used to compare Hip Outcome Score Activities of Daily Living (HOS-ADL), Hip Outcome Score Sport-Specific (HOS-SS), and modified Harris Hip Score (mHHS) between the 2 cohorts at 2 years of follow-up. Results: A total of 624 patients were included, with an average age of 34.0 ± 13.5 years; 235 (37.7%) patients had experienced preoperative symptoms 2 years or longer. Patients with symptoms lasting less than 2 years had statistically significant higher outcome scores than those with symptoms lasting 2 or more years for the HOS-ADL (86.3 ± 16.4 vs 80.3 ± 19.9, respectively), HOS-SS (75.0 ± 25.3 vs 65.1 ± 29.0), and mHHS (79.1 ± 16.6 vs 74.0 ± 18.8), as well as higher satisfaction (82.1 ± 30.7 vs 71.1 ± 31.6) and lower pain scores (2.6 ± 2.3 vs 3.5 ± 2.6). On multivariate analysis, patients with symptoms 2 years or longer had significantly higher visual analog scale–Pain score (β = 0.6, P = .039) and lower HOS-ADL (β = −3.4, P = .033), HOS-SS (β = −6.3, P = .012), and satisfaction (β = −6.7, P = .028) at 2-year follow-up. Patients with longer duration of symptoms also demonstrated less improvement in HOS-SS (β = −10.3, P = .001) at 2 years after surgery. Patients with symptoms for 2 years or longer were significantly less likely to achieve a patient acceptable symptomatic state for HOS-ADL (relative risk [RR] = 0.8, P = .024) and HOS-SS (RR = 0.8, P = .032) at 2 years of follow-up. Patients with symptoms 2 years or longer also demonstrated significantly higher rates of revision arthroscopy (RR = 10.1, P = .046). Conclusion: Patients with untreated, FAIS-related symptoms lasting 2 years or longer before arthroscopic management had significantly worse patient-reported outcomes and higher rates of reoperation at 2 years after surgery when compared with those patients with a shorter duration of preoperative symptoms.

scholarly journals Is there a gender gap in outcomes after hip arthroscopy for femoroacetabular impingement? Assessment of clinically meaningful improvements in a prospective cohort

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0043
Author(s):  
Sergio Flores ◽  
Caitlin Chambers ◽  
Kristina Borak ◽  
Alan Zhang
Keyword(s):  
Femoroacetabular Impingement ◽  
Gender Gap ◽  
Hip Arthroscopy ◽  
Short Form ◽  
Patient Reported Outcome ◽  
Harris Hip Score ◽  
Power Calculation ◽  
Age Group ◽  
Patient Gender ◽  
Patient Reported

Objectives: Although patients have been found to have significant improvements after hip arthroscopy for femoroacetabular impingement (FAI), prior studies suggest women have worse outcomes compared to men. These previous studies lack comparisons of patient reported outcome (PRO) scores based on gender with respect to clinical significance measurements, including the minimal clinically important difference (MCID) and patient acceptable symptom state (PASS). Therefore, the purpose of this study is to evaluate outcomes following hip arthroscopy for FAI based on patient gender by prospectively assessing changes in PRO scores, MCID, and PASS. Methods: Women and men undergoing hip arthroscopy for FAI were prospectively enrolled and preoperative radiographic and intra-operative findings were collected. The cohort was stratified based on self-identified patient gender so the term gender as well as the terms women and men were used to describe the patients as opposed to sex and the terms female and male. Patients completed the following PRO surveys before surgery and 2-years postoperatively: modified Harris Hip Score (mHHS), Hip disability and Osteoarthritis Outcome Score (HOOS), and the 12-Item Short Form Health survey (SF-12). Mean scores and the percentage of patients reaching MCID and PASS were analyzed. An a priori power calculation was performed which determined 42 hips in each group were needed to adequately power the study to 95%. Results: A total of 131 hips, from 72 women and 59 men were included. The mean ± SD age for women and men was 34.2 ± 9.5 vs 35.8 ± 10.3 years, respectively; P= .347 and body mass index (BMI) of 24.9 ± 4.4 vs 25.5 ± 3.3 kg/m2, respectively; P= .379. Women had smaller preoperative alpha angles (59.1 vs 63.7, respectively; P< 0.001) and lower acetabular cartilage injury grade (6.9% vs 22.0% with grade 4 injury, respectively; P= 0.013). Both women and men achieved equivalent significant improvements in PRO scores after surgery (PRO scores increased 18.4 to 45.1 points for mHHS and HOOS). Women and men reached PASS for mHHS at similar rates (76.4% and 77.2%, respectively; P=0.915). MCID was also achieved at similar rates between women and men for all scores (ranged 61.4% to 88.9%) except HOOS-ADL in which a higher percentage of women reached MCID compared to men (79.2% vs 62.7%, respectively; P= .037). Additional stratification by age group using the median cohort age of 34 showed no significant differences in PRO improvement based on age group for each gender. Conclusions: Women can achieve clinically meaningful improvements in patient reported outcomes scores after hip arthroscopy for FAI. Compared to men, women demonstrated equivalent high rates of achieving MCID and PASS at 2 years following surgery. [Table: see text]

Assessment of Disability Related to Femoroacetabular Impingement Syndrome by Use of the Patient-Reported Outcome Measure Information System (PROMIS) and Objective Measures of Physical Performance

2017 ◽  
Vol 45 (11) ◽  
pp. 2476-2482 ◽  
Author(s):  
Andrew J. Sheean ◽  
Matthew R. Schmitz ◽  
Catherine L. Ward ◽  
Aaron E. Barrow ◽  
David J. Tennent ◽  
...  
Keyword(s):  
Physical Performance ◽  
Performance Measures ◽  
Femoroacetabular Impingement ◽  
Patient Reported Outcome ◽  
Step Test ◽  
Harris Hip Score ◽  
Objective Measures ◽  
Level Of Evidence ◽  
Femoroacetabular Impingement Syndrome ◽  
Patient Reported

Background: The National Institutes of Health (NIH)–sponsored Patient-Reported Outcomes Measurement System (PROMIS) has been described as a valuable tool for characterizing outcomes among patients with specific musculoskeletal conditions. Additionally, previously proposed objective measures of physical performance among patients with nonarthritic hip abnormalities are costly and not practically incorporated into routine clinical practice. Purpose: (1) To determine the ability of the PROMIS to differentiate between patients with femoroacetabular impingement (FAI) and asymptomatic controls, (2) to determine the effect of FAI on subjects’ completion of timed physical performance measures, and (3) to determine whether associations exist between established patient-reported outcome (PRO) measures and subjects’ completion of physical performance measures. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Twenty-two asymptomatic controls (CON group) and 20 patients with FAI completed multiple activities to assess physical ability: self-selected walking velocity (SSWV), timed stair ascent (TSA), four-square step test (FSST), and sit-to-stand five times test (STS5). All subjects also underwent a battery of PRO questionnaires: Visual Analog Scale for Pain (VAS), Modified Harris Hip Score (mHHS), International Hip Outcome Tool (iHOT-33), Hip Disability and Osteoarthritis Outcome Score (HOOS), and PROMIS. Descriptive analyses were performed and comparisons between groups were made by use of paired t tests with Bonferroni-Holm correction. Spearman’s rank correlation coefficients were used to determine associations between physical performance measures and PRO. The magnitude of differences between groups for each measured variable was calculated by use of Cohen’s d. Results: Significant differences between CON and FAI groups were observed for all hip-specific PRO measures (CON vs FAI for all; HOOS 99.2 vs 42.8, P < .001, iHOT-33 99.0 vs 26.6, P < .001, mHHS 99.6 vs 62.2, P < .001). Similarly, PROMIS scores were significantly different between groups for 8 of 9 tested domains. Patients with FAI demonstrated significant decrements in performance of all tested physical measures compared with asymptomatic controls (CON vs FAI, SSWV: 1.51 vs 1.32 m/s, P = .002; TSA: 3.05 vs 5.92 s, P = .017; FSST: 4.83 vs 8.89 s, P = .006; STS5: CON 5.53 vs FAI 10.75 s, P = .005.) Deficits in activities involving hip flexion—TSA, STS5—were strongly associated ( r < –0.7, P < .001) with increased reports of disability. Conclusion: FAI has a negative effect on patient-reported and objectively measured function. Hip-specific and general measures such as PROMIS, FSST, TSA, and STS5 are responsive to FAI-associated debility and may be used to objectively assess surgical or rehabilitative outcomes.

scholarly journals Correlation of the squat-and-smile test against other patient-reported outcome scores in knee pathology

2021 ◽  
Vol 20 (3) ◽  
Author(s):  
Johan le Roux ◽  
Roopam Dey ◽  
Andrea S Deichl ◽  
Oscar Torney ◽  
Maritz Laubscher ◽  
...  
Keyword(s):  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Sub Saharan Africa ◽  
Poor Correlation ◽  
Level Of Evidence ◽  
Large Hospital ◽  
Femur Fractures ◽  
Outcome Score ◽  
Patient Reported ◽  
Knee Pathology

ABSTRACT BACKGROUND: The use of patient-reported outcome measures (PROMs) for knee pathology may be affected by socioeconomic factors, language barriers and time constraints in busy outpatient clinics. The squat-and-smile test (SST) is an example of such a test that has previously been validated for femur fractures. The aim of this study was to validate the SST against other PROMs in patients with knee pathology METHODS: Patients presenting to a subspecialist knee clinic in a large hospital in sub-Saharan Africa were approached to participate. They were asked to squat and the depth of the squat as well as the need to support themselves were classified into four categories. To describe their pain, participants also selected one of three smiley faces (unhappy, neutral, smiling). These test scores were correlated to the patient's Knee injury and Osteoarthritis Outcome Score (KOOS), Tegner Lysholm score and EQ-5D scores RESULTS: Seventy patients (median age 53.4 years) were included. The squat depth correlated moderately with the KOOS score (r=0.56) and poorly with the EQ-5D and Lysholm scores (r=0.46; r=0.43). The need for squat support had poor correlations with the KOOS, EQ-5D and Lysholm scores (r=0.29; r=0.31; r=0.31), as did the smiley face component (r=0.40; r=0.32; r=0.30 CONCLUSION: For patients with knee pathology, the squat depth correlates moderately with other PROMs. It could therefore be used in settings for which conventional PROMs have limited application. Support needed to squat, and a visual analogue scale of smiley faces, had poor correlation when compared to other knee PROMs and should not be used for the assessment of knee pathology Level of evidence: Level 4 Keywords: squat and smile, KOOS, PROM, smiley faces, outcome score

Multicenter Outcomes After Revision Hip Arthroscopy: Comparative Analysis of 2-Year Outcomes After Labral Repair Versus Labral Reconstruction

2021 ◽  
pp. 036354652110305
Author(s):  
Blake M. Bodendorfer ◽  
Thomas D. Alter ◽  
Andrew B. Wolff ◽  
Dominic S. Carreira ◽  
John J. Cristoforetti ◽  
...  
Keyword(s):  
Hip Arthroscopy ◽  
A Priori ◽  
Cartilage Damage ◽  
Labral Repair ◽  
Harris Hip Score ◽  
Level Of Evidence ◽  
Outcome Score ◽  
Center Edge ◽  
Labral Tears ◽  
Patient Reported

Background: There is a paucity of literature evaluating patient outcomes in patients undergoing revision labral repair and labral reconstruction. Purpose: To compare outcomes in patients undergoing revision hip arthroscopy for treatment of labral tears by labral repair or labral reconstruction. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review of a prospectively maintained multicenter database of patients undergoing hip arthroscopy was performed. An a priori power analysis determined that a total of 62 patients were required. Patients undergoing revision hip arthroscopy for labral tears with completed 2-year outcome scores were included. Patients undergoing primary hip arthroscopy, labral debridement, concomitant gluteal repair, and patients with hip dysplasia (lateral center-edge angle <20°) were excluded. Patients were grouped into revision labral repair and labral reconstruction groups. Patient demographics and patient-reported outcomes (PROs) including Hip Outcome Score – Activities of Daily Living, Hip Outcome Score – Sport Subscale, modified Harris Hip Score, international Hip Outcome Tool-12, visual analog scale for pain and satisfaction, and achievement of minimal clinically important difference (MCID) and Patient Acceptable Symptom State (PASS) were analyzed. Results: A total of 40 patients underwent revision labral repair and 55 patients underwent labral reconstruction. Patients undergoing revision labral repair were younger (mean age, 30.0 ± 10.7 years vs 34.4 ± 9.7 years; P = .048), had lower rates of labral degeneration (25.0% vs 62.7%; P = .004), and had lower rates of severe complexity of tears (21.1% vs 66.0%; P = .003). However, the labral repair group had higher rates of articular cartilage damage (62.5% vs 33.3%; P = .009). There were no differences in any preoperative or 2-year postoperative PROs. Furthermore, no differences were seen in achievement of MCID or PASS in any PRO. Conclusion: In this multicenter study on revision hip arthroscopy, patients undergoing revision labral repair were younger and had better labral characteristics but greater cartilage damage compared with patients undergoing labral reconstructions. Despite these differences, patients who underwent labral repair reported similar outcomes to those undergoing labral reconstruction.

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