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Presenter discusses substantial clinical benefit as measure of clinical success after hip arthroscopy for FAI
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SAN DIEGO — Substantial clinical benefit may be a more effective measure to determine clinical success in patients who underwent hip arthroscopy for femoroacetabular impingement, according to a presentation at the American Academy of Orthopaedic Surgeons Annual Meeting.
“[Substantial clinical benefit] SCB defines the level of considerable outcome improvement beyond what we understand with [minimal clinically important difference] MCID,” Benedict U. Nwachukwu, MD, said. “I think that MCID and SCB can be considered complimentary measures of clinical significance for assessing outcomes, with MCID being the minimal threshold and SCB being the upper threshold.”
He added, “When taken together, I think these findings have a point and implications for grading outcomes after hip arthroscopy and potentially for counseling patients preoperatively.”
Nwachukwu and colleagues prospectively administered the modified Harris Hip score (mHHS), hip outcome score (HOS) and the International Hip Outcome Tool (iHOT-33) to 364 patients who were arthroscopically treated for femoroacetabular impingement. At 1 year postoperatively, patients assessed their hip function with regard to anchor responses, such as “no change” or “much improved.” Values that were sensitive and specific for the SCB were determined with receiver operating characteristic analysis and area under the curve. Predictive values for SCB were determined with multivariable analysis.
Results showed the net score change from preoperative to postoperative values for the mHHS, HOS activities of daily living (HOS ADL), HOS sport and iHOT-33 was 19.8, 10, 29.9 and 24.5, respectively. Patients had a decreased chance of achieving SCB if they scored higher than the following preoperative thresholds: 83.3 for HOS ADL, 50 for HOS sport and 46.9 for iHOT-33. Negative predictors for achieving SCB included higher preoperative functional status, older age, higher outerbridge grading and relative acetabular retroversion at 2°. – by Monica Jaramillo
Reference:
Nwachukwu BU, et al. Paper #26. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 14-18, 2017; San Diego.
Disclosure: Nwachukwu reports no relevant financial disclosures.