ISAKOS Congress 2021

2021 ISAKOS Biennial Congress ePoster

 

Psychologically Distressed Patients Can Obtain Meaningful Clinical Benefit from Arthroscopic Hip Surgery

Benjamin Saks, MD, Des Plaines, IL UNITED STATES
Rachel Glein, BS, Des Plaines, Illinois UNITED STATES
Hari Krishna Ankem, MD, Chicago, ILLINOIS UNITED STATES
Andrew Jimenez, MD, Chicago, Illinois UNITED STATES
Payam William Sabetian, MD, Chicago, IL UNITED STATES
Ajay C. Lall, MD, MS, Des Plaines, Illinois UNITED STATES
Benjamin G. Domb, MD, Des Plaines, IL UNITED STATES

American Hip Institute Research Foundation, Des Plaines, Illinois, UNITED STATES

FDA Status Cleared

Summary

Psychologically Distressed Patients Can Obtain Meaningful Clinical Benefit

ePosters will be available shortly before Congress

Abstract

Background

There is evidence to suggest that psychological distress can negatively affect the outcomes of arthroscopic hip surgery for femoroacetabular impingement.

Purpose

To evaluate the influence of psychological distress on patient reported outcomes following arthroscopic hip surgery for femoroacetabular impingement at a minimum of five years.

Study Design: Cohort study; Level of evidence, 3.

Methods

Demographic and intraoperative data were prospectively collected on all patients who underwent primary arthroscopic hip surgery between June 2012 and December 2014. All included patients had preoperative and minimum five-year postoperative scores for the 12-item Short Form Health Survey (SF-12), the Modified Harris Hip Score (mHHS), the Nonarthritic Hip Score (NAHS), the International Hip Outcome Tool (iHOT), the Visual Analog Scale (VAS) for pain and satisfaction. The SF-12 Mental Component Score (MCS) was utilized to stratify patients into two cohorts. Patients with an average or above average score (SF-12 MCS = 50) were considered to be psychologically non-distressed, while those who scored below average (SF-12 MCS < 50) were considered to have psychological distress. Distressed patients were then propensity matched by age, gender, and body mass index (BMI), to an equal number of non-distressed patients.

Results

Of the 153 hips which met inclusion criteria for this study, 117 hips (107 patients) were available for analysis with minimum 5-year follow-up (76.5%). Eighty-two hips (77 patients) were included in the final analysis after propensity matching, with 41 in both the distressed and non-distressed cohorts. At the preoperative timepoint, patients in the distressed cohort reported significantly lower scores for all patient reported outcome measures (PROs) except for the mHHS, though the trend approached significance (P=0.061). At minimum 5-year follow-up, there were no differences between groups for any PRO. There were no differences in the rates of achieving minimal clinically important difference (MCID) for the mHHS, NAHS, or iHOT or attainment of the threshold score for patient acceptable symptomatic state (PASS) for the mHHS. There were no significant difference in the numbers of secondary surgeries performed.

Conclusion

Patients with baseline psychological distress may still gain meaningful clinical benefit from arthroscopic hip surgery, with midterm outcomes comparable to those obtained by patients without.

International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine

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