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Symptom duration predicts inferior mid-term outcomes following hip arthroscopy

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Abstract

Introduction

Studies have demonstrated a negative relationship between the length of time with symptoms and patient-reported outcome measures in primary hip arthroscopy. Our aim was to expand the generalizability of this finding with a multi-center cohort.

Methods

A multi-center hip arthroscopy registry was queried for patients undergoing primary hip arthroscopy from 2014 to 2017. Patients were stratified according to whether pre-operative symptom duration exceeded two years or did not exceed two years. A Wilcoxon rank sum test was performed for differences in two year post-operative outcome scores. Logistic regression models analyzed the influence of symptom duration on achieving clinically meaningful thresholds (minimum clinically important difference, patient-acceptable symptom state, substantial clinical benefit) when controlling for baseline scores, age, BMI, and sex.

Results

Seven hundred forty-four patients met the inclusion criteria, from which 620 had complete outcomes information. The mean ± SD 2-year iHOT-12 scores of patients with symptom duration greater than two years (69 ± 26) were significantly lower than patients with symptom duration less than two years (77 ± 23) (Dunn test, p < 0.001). Chronic duration of pain was a negative predictor of achieving iHOT-12 MCID (0.47 [0.31–0.72]), PASS (0.53 [0.37–0.76]), and SCB (0.67 [0.47–0.94]).

Conclusion

When controlling for differences in baseline demographic factors and pre-operative iHOT-12 scores, patients with chronic pain report poorer functional outcomes at mid-term follow-up. These results suggest that chronic pain predicts inferior outcomes from primary hip arthroscopy and that surgical intervention at earlier time points may be beneficial in achieving better outcomes.

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Funding

This work was supported by funding from a grant provided by the SICOT Research Academy in 2019.

Author information

Authors and Affiliations

  1. Peachtree Orthopedics, Atlanta, GA, USA

    Dominic S. Carreira & Daniel B. Shaw

  2. Hip Preservation and Sports Medicine, Washington Orthopaedics and Sports Medicine, Washington, DC, USA

    Andrew B. Wolff

  3. Hip Preservation and Sports Medicine, Texas Health Physicians Group, Dallas, TX, USA

    John J. Christoforetti

  4. Rothman Orthopaedic Institute, Philadelphia, PA, USA

    John P. Salvo

  5. Duquesne University, Pittsburgh, PA, USA

    Benjamin R. Kivlan

  6. DISC Sports and Spine Center, Marina del Rey, CA, USA

    Dean K. Matsuda

Authors
  1. Dominic S. Carreira
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  2. Daniel B. Shaw
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  3. Andrew B. Wolff
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  4. John J. Christoforetti
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  5. John P. Salvo
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  6. Benjamin R. Kivlan
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  7. Dean K. Matsuda
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Contributions

All authors made substantial contributions to the conception and design of the study. The first draft of the manuscript was written and prepared by Daniel Shaw. All authors were instrumental in editing and revising the manuscript. All authors approved the current edition of the manuscript for submission.

Corresponding author

Correspondence to Dominic S. Carreira.

Ethics declarations

Ethics approval

This is a retrospective outcomes study. The Institutional Review Board at Piedmont Hospital has confirmed that no ethics approval is required. IRB: Piedmont Healthcare IRB: Atlanta, GA.

Consent to participate

Informed consent was obtained from all participating individuals prior to enrollment in the study registry.

Consent for publication

All participants were informed that their data may be used for the purposes of publication, and they consented to have their data used for this purpose.

Competing interests

Daniel Shaw and Benjamin Kivlan declare that they have no financial interests. Dominic Carreira declares that he has received consulting fees from Zimmer Biomet, Linvatec, and DePuy Orthopaedics and payment for expert opinion from Arthrex Inc., Smith & Nephew, and Wright Medical Technology. Andrew Wolff declares that he has received payment for consulting from Arthrex Inc. and Stryker Corporation. John Christoforetti declares that he has received research funding from Allegheny Singer Research Institute, payment for consulting from Arthrex Inc. and Stryker Corporation, and payment honoraria from Mid-Atlantic Surgical Systems LLC. John Salvo declares that he has received payment for consulting from Stryker Corporation and payment honoraria from Liberty Surgical Inc. Dean Matsuda declares that he has received royalties from Zimmer Biomet and Smith & Nephew and payment for expert testimony from Pacira Pharmaceuticals.

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Carreira, D.S., Shaw, D.B., Wolff, A.B. et al. Symptom duration predicts inferior mid-term outcomes following hip arthroscopy. International Orthopaedics (SICOT) 46, 2837–2843 (2022). https://doi.org/10.1007/s00264-022-05579-8

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