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Violation of expectations is correlated with satisfaction following hip arthroscopy

  • HIP
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The mechanism by which preoperative expectations may be associated with patient satisfaction and procedural outcomes following hip preservation surgery (HPS) is far from simple or linear. The purpose of this study is to better understand patient expectations regarding HPS and their relationship with patient-reported outcomes (PROs) and satisfaction using machine learning (ML) algorithms.

Methods

Patients scheduled for hip arthroscopy completed the Hip Preservation Surgery Expectations Survey (HPSES) and the pre- and a minimum 2 year postoperative International Hip Outcome Tool (iHOT-33). Patient demographics, including age, gender, occupation, and body mass index (BMI), were also collected. At the latest follow-up, patients were evaluated for subjective satisfaction and postoperative complications. ML algorithms and standard statistics were used.

Results

A total of 69 patients were included in this study (mean age 33.7 ± 13.1 years, 62.3% males). The mean follow-up period was 27 months. The mean HPSES score, patient satisfaction, preoperative, and postoperative iHOT-33 were 83.8 ± 16.5, 75.9 ± 26.9, 31.6 ± 15.8, and 73 ± 25.9, respectively. Fifty-nine patients (86%) reported that they would undergo the surgery again, with no significant difference with regards to expectations. A significant difference was found with regards to expectation violation (p < 0.001). Expectation violation scores were also found to be significantly correlated with satisfaction.

Conclusion

ML algorithms utilized in this study demonstrate that violation of expectations plays an important predictive role in postoperative outcomes and patient satisfaction and is associated with patients’ willingness to undergo surgery again.

Level of evidence

IV.

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Abbreviations

HPS:

Hip preservation surgery

PROs:

Patient-reported outcomes

ML:

Machine learning

HPSES:

Hip preservation surgery expectations survey

i-HOT-33:

International hip outcome tool

BMI:

Body mass index

mHHS:

Modified harris hip score

HOS-ADL:

Hip outcome score-activities of daily living subscale

FAIS:

Femoral acetabular impingement syndrome

EXPVIO:

Expectations violation

AGAIN:

Patients who reported having the operation again to those regretting the operation

VS-MPR:

Vovk-sellke maximum p-ratio

MCID:

Minimal clinically important difference

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Funding

No funding was received for this project.

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Authors and Affiliations

  1. Orthopedic Division, Department of Orthopedic Surgery, Affiliated with the Sackler Faculty of Medicine, Tel Aviv Medical Center, 6 Weitzman St., 6423906, Tel Aviv, Israel

    Shai Factor, Matias Vidra, Moshe Shalom, Adi Lichtenstein, Eyal Amar & Ehud Rath

  2. Department of Cognitive and Brain Sciences and the Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, 84105, Beer-Sheva, Israel

    Yair Neuman

Authors
  1. Shai Factor
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  6. Eyal Amar
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  7. Ehud Rath
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Contributions

ER and EA: are equally contributing last authors to this article. All authors that have contributed to this manuscript have agreed on the final revised version of this manuscript. Data are available at reasonable request from the corresponding author.

Corresponding author

Correspondence to Shai Factor.

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0402–13-TLV.

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Factor, S., Neuman, Y., Vidra, M. et al. Violation of expectations is correlated with satisfaction following hip arthroscopy. Knee Surg Sports Traumatol Arthrosc 31, 2023–2029 (2023). https://doi.org/10.1007/s00167-022-07182-1

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  • DOI: https://doi.org/10.1007/s00167-022-07182-1

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