2021 ISAKOS Biennial Congress ePoster
Psychologically Distressed Patients Can Obtain Meaningful Clinical Benefit from Arthroscopic Hip Surgery
Benjamin Saks, MD, Exeter, New Hampshire UNITED STATES
Rachel Glein, BS, Des Plaines, Illinois UNITED STATES
Hari Krishna Ankem, MD, Louisville, KENTUCKY UNITED STATES
Andrew Jimenez, MD, Chicago, Illinois UNITED STATES
Payam William Sabetian, MD, Guatemala, Guatemala GUATEMALA
Ajay C. Lall, MD, MS, FAAOS, Paramus, New Jersey UNITED STATES
Benjamin G. Domb, MD, Chicago, 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.