Summary

Hip arthroscopy for the treatment of femoroacetabular impingement and labral tears in patients with depression and anxiety resulted in significant midterm improvements in functional and health-related quality of life scales.

Abstract

Purpose

To report midterm outcomes of patients with depression and anxiety who underwent hip arthroscopy for femoroacetabular impingement (FAI) and labral tears compared to a benchmark control group of patients without depression and anxiety.

Methods

Data was retrospectively analyzed for patients with a self-reported history of depression and/or anxiety who underwent primary hip arthroscopy from 2008-2018. Included patients had at least one of the following patient reported outcome (PRO) scores; modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score–Sports-Specific Subscale (HOS-SSS), International Hip Outcome Tool (iHOT-12), Short Form 12 – Mental (SF-M), Veterans RAND 12 Item - Mental (VR-M); or a documented endpoint during the study period. Patients were propensity matched to a benchmark control group of patients without depression and anxiety in a 1:1 ratio based on sex, age at surgery, body mass index, acetabular outerbridge grade, labral treatment, and capsular treatment. Clinically relevant thresholds, revision surgeries, and conversion to arthroplasty rates were also included in the analysis.

Results

125 hips with depression/anxiety were included in the study and were successfully matched to 125 control hips without depression and anxiety. The depression/anxiety group started with significantly lower preoperative scores for HOS-SSS, SF-M, and VR-M. Both groups demonstrated similar magnitudes of improvement across all evaluated PROs. However, patients with anxiety and depression had significantly lower mid-term scores for mHHS, NAHS, HOS-SSS, SF-M, and VR-M, and achieved PASS at lower rates for mHHS and HOS-SSS. There was no significant difference between the two groups regarding secondary surgeries and complications.

Conclusion

Hip arthroscopy for the treatment of FAI and labral tears in patients with depression and anxiety resulted in significant midterm improvements in functional and health-related quality of life scales. However, this patient population achieved lower mean postoperative scores and achieved PASS at a lower rate.