2021 ISAKOS Biennial Congress Paper
The Relationship Between Early And Mid-Term Hip Arthroscopy Outcomes: Employing 3 Month Follow-Up To Predict Mid-Term Results
Mario Hevesi, MD, PhD, Rochester, MN UNITED STATES
Ajay C. Lall, MD, MS, FAAOS, Paramus, New Jersey UNITED STATES
David E. Hartigan, MD, Robbinsdale , Mn UNITED STATES
Bruce A. Levy, MD, Orlando, Florida UNITED STATES
Benjamin G. Domb, MD, Chicago, IL UNITED STATES
Aaron J. Krych, MD, Rochester, MN UNITED STATES
Mayo Clinic, Rochester, MN, UNITED STATES
FDA Status Not Applicable
Summary
Early, 3 month patient reported VAS, mHHS, and HOS-SSS scores substantially predict reoperation risk at mid-term follow-up.
Abstract
Introduction
Hip arthroscopy is commonly performed with established safety and efficacy. However, follow-up protocols after arthroscopy are yet to be standardized. Given the financial, logistical, and recent epidemic-related considerations of medical travel, it would be of utility to identify both low- and high-risk patients in order to tailor timing of in-person and electronic clinic visits. The purpose of this multicenter study was to use early postoperative outcomes to predict mid-term outcomes and reoperation rates following hip arthroscopy.
Methods
Prospectively collected data for primary hip arthroscopies at two high-volume centers 2008-2014 were analyzed using Visual Analog Scale (VAS), modified Harris Hip Score (mHHS), and Hip Outcome Score–Sports Specific Subscale (HOS-SSS) and their associated published Minimum Clinically Important Difference (MCID, VAS: 2.0, mHHS: 13.0, HOS-SSS: 28.0). Outcomes from 3 month follow-up were evaluated for their prognostic value for mid-term outcomes and revision rates.
Results
1,100 patients (348 M, 608 F, age: 37.1±13.8 years) undergoing hip arthroscopy were followed for a mean of 3.6±1.6 years (range: 2.0–8.6). At 3 months following surgery, patients experienced statistically significant (p<0.001) improvements in all outcome scores, with 69% achieving MCID for VAS, 96% for mHHS, and 94% for HOS-SSS.
At final follow-up, 145 (13%) patients had undergone reoperation, with 66 (6%) proceeding to total hip arthroplasty. Early outcomes were found to be highly significant in predicting reoperation, with each single digit point decrease in 3 month VAS (HR: 1.17, p<0.001) and increase in mHHS (HR: 0.98, p<0.001) and HOS-SSS (HR: 0.99, p<0.01) decreasing reoperation risk by 17%, 2%, and 1%, respectively.
Discussion And Conclusion
Prognosticating recovery is of substantial clinical utility following hip arthroscopy. Early, 3 month patient reported VAS, mHHS, and HOS-SSS scores substantially predict reoperation risk at mid-term follow-up.