Six Month Outcome Scores Predicts Short Term Outcomes After Hip Arthroscopy.
2021
ABSTRACT Purpose To determine if early PRO improvements in the 6 months after surgery are predictive of achieving a patient acceptable symptomatic state (PASS) at 2 years. Methods A prospectively collected database was retrospectively reviewed. Inclusion criteria included patients ≥ 18 years of age, Tonnis grade 0 or 1 changes, radiographic imaging consistent with FAI or labral pathology, a primary diagnosis of symptomatic FAI for which they underwent primary hip arthroscopy and had baseline, 6 month and 2 year modified Harris Hip Score (mHHS) scores. Revision cases were excluded. ROC curve analysis was conducted to determine if 6month changes in mHHS was a predictor for achieving PASS at 2 years. Results There were 173 patients (mean age: 39.8, 61.8% females) included within the study. Patients who do not achieve the minimal clinically important difference (MCID), defined as a change of 8 points in mHHS, by 6 months (n = 21) tended to have significantly lower mHHS scores at 1 year and 2 years compared to those that did (n = 152). Only 52% of patients that did not achieve MCID by 6 months achieved MCID by 2 years (vs. 98% for those that did) and only 24% achieved PASS by 2 years (vs. 88% that did). Using the MCID as a cutoff for improvement in mHHS at 6 months results in a 96% sensitivity but 47% specificity for predicting PASS achievement at 2 years. Using 24 points of improvement in mHHS as a cutoff at 6 months improves sensitivity and specificity to 81% and 80%, respectively. Conclusions Early improvement in mHHS scores are associated with 2 year outcomes. Patients who do not achieve MCID within 6 months of surgery have a high rate of not achieving PASS at 2 years.
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