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Patients with Associated Spine Or Other Major Joint Pain Have Equivalent Outcomes To Patients With Isolated Hip Pain After Hip Arthroscopy


Ivan Wong, MD, FRCSC, MACM, Dip. Sports Med
CANADA

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Patients with Associated Spine Or Other Major Joint Pain Have Equivalent Outcomes To Patients With Isolated Hip Pain After Hip Arthroscopy

Sarah Remedios, MSc, PhD(c), CANADA Ivan Wong, MD, FRCSC, MACM, Dip. Sports Med, CANADA

Nova Scotia Health, Halifax, Nova Scotia, CANADA

2023 Congress   ePoster Presentation   2023 Congress   Not yet rated

 

Anatomic Location

Hip / Groin / Thigh

Summary: Patients with hip, spine, and other major joint pain have inferior outcomes compared with patients with MSM grade 1-3.

Objective

Post-operative outcomes following hip arthroscopy for Femoroacetabular impingement (FAI) can be assessed using a variety of patient-reported outcomes (PROs). It has recently been found that pain in other major joints, including the spine and knee, may negatively affect patient outcomes post-operatively. The objective of our study was to assess post-operative outcomes in patients treated arthroscopically for FAI and to determine whether presence of pain in other joints affects PRO scores pre- and post-operatively.

Methods

Patients who underwent hip arthroscopy for FAI between 2016-2020 with a minimum 2-year follow-up were reviewed. Patients were included if they had available pre-operative pain diagrams. Patients were then grouped into Musculoskeletal Morbidity (MSM) grades (Grade 1: hip pain only; Grade 2: hip and other major joint pain; Grade 3: hip and spine pain; Grade 4: hip, spine, and other major joint pain). Patients were excluded if they had: a history of ipsilateral hip surgery; <2 mm of joint space; and if they underwent an additional surgery other than the contralateral leg within 6 months of primary surgery. Primary outcomes included pre- and post-operative International Hip Outcome Tool (iHOT-33).

Results

One hundred-seventeen patients were evaluated with a mean age of 37.16 years at the time of the surgery. The mean duration of follow-up was 31.5 months. Patients with MSM Grade 4 had significantly lower (i.e. worse) iHOT-33 scores (21.54±13.38) than MSM Grade 1 patients (40.07±20.97) at the pre-operative time point (p=0.006). Interestingly, all patients improved post-operatively (MSM 1-3 p<0.001; MSM 4 p=0.005). While MSM grade 4 patients had lower post-operative iHOT-33 scores (54.88±30.26) compared to Grades 1-3 (68.95±25.78, 68.28±28.99, 68.01±30.50, respectively).

Conclusions

Treatment of FAI with hip arthroscopy yields improved iHOT-33 scores and patients with associated spine or other major joint pain have equivalent outcomes to patients with isolated hip pain. Patients with hip, spine, and other major joint pain have inferior outcomes compared with patients with MSM grade 1-3.

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