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Age, radiographic OA seen as main drivers of appropriate use criteria for hip preservation surgery
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Variables that contributed the most to the appropriateness classification system for hip preservation surgery published by the American Academy of Orthopaedic Surgeons included age and radiographic hip osteoarthritis evaluation, according to results.
“Variables most relevant to patients including hip motion restriction and function-limiting hip pain did not contribute in a meaningful way to the [American Academy of Orthopaedic Surgeons] AAOS hip preservation surgery appropriate use classification system,” Daniel L. Riddle, PT, PhD, FAPTA, told Healio.com/Orthopedics. “Rather, more traditional hip radiographic measures and age dominated the classifications. These findings raise fundamental questions regarding the potential usefulness of the AAOS classification system.”
The AAOS published a classification system to determine the appropriateness of hip preservation surgery that used the RAND/UCLA approach. A multidisciplinary expert panel appointed by AAOS wrote 270 clinical vignettes that encompassed permutations of five indication variables from an evidence synthesis. During various Delphi surveys, the appropriateness of each vignette was rated by a second, independent expert panel. The relative contribution of each variable to classification was determined with logistic regression. Variables that contributed to the final classification were determined with a classification tree approach.
Results from the logistic regression showed the main indications of appropriateness classification were patient age and radiographic hip osteoarthritis evaluation. Variables that did not meaningfully contribute to the final classification included hip range of motion, risk for negative outcome and function-limiting pain. – by Monica Jaramillo
Disclosures: The researchers report no relevant financial disclosures.
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