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Minimal clinically important difference, substantial clinical benefit may be reached 6 months after hip arthroscopy for FAI
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Minimal clinically important difference and substantial clinical benefit were achieved among half of patients treated with hip arthroscopy for femoroacetabular impingement within the first 6 months postoperatively, according to results published in The American Journal of Sports Medicine, with clinically significant outcome improvements continuing until 2 years postoperatively.
Benedict U. Nwachukwu, MD, MBA, and colleagues administered the modified Harris hip score, hip outcome score and 33-item international hip outcome tool (iHOT-33) to 719 patients undergoing hip arthroscopy for femoroacetabular impingement (FAI) preoperatively and at follow-up time frames of 6 months, 1 year and 2 years. Researchers calculated cumulative probabilities for achieving a minimal clinically important difference (MCID) and substantial clinical benefit (SCB) using Kaplan Meier survival curve analysis and interval censoring, while the odds of achieving earlier MCID was evaluated with a Weibull parametric regression analysis.
By the 6-month postoperative period, results showed patients had the highest probability for achieving MCID and substantial clinical benefit across all four outcome instruments. The highest probability for capturing MCID was demonstrated by the iHOT-33, with achievement of MCID of 76%, 84.8% and 93.6% by 6 months, 1 year and 2 years, respectively, according to results. Researchers also found iHOT-33 had the highest probability for capturing SCB, with achievement of 57.1% at 6 months, 68% at 1 year and 71.7% at 2 years. Results showed other outcome tools demonstrated a similar trend. Researchers noted a significantly increased risk for taking a longer time to achieve MCID and SCB among older male patients, patients with Outerbridge classification 1 to 4 and patients with higher preoperative outcome scores.
“In our study, we looked at the time that it takes for our patients to achieve [a] minimal clinically important difference and substantial clinical benefit after hip arthroscopy,” Nwachukwu told Healio.com/Orthopedics. “We found that the greatest probability for achieving [a] clinically significant outcome was within the first 6 months after surgery; however, patients do continue to show clinically significant outcome improvement out to 2 years from surgery. This suggests that for the arthroscopic treatment of hip impingement, patients should be followed out until at least 2 years if they have not achieved [an] excellent outcome. Additionally, this information can be helpful for counseling patients during their recovery process.” – by Casey Tingle
Disclosures: Nwachukwu reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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