Hip Arthroscopy: 6-Month Improvements Predict 2-Year Satisfaction

To what extent do hip arthroscopy patients who are happy at the six month mark remain satisfied two years later? And…do these early patient-reported outcomes have predictive value? That is what a team of researchers from the New York University (NYU) Langone Orthopedic Hospital sought to determine with their study, “Six-Month Outcome Scores Predicts Short-Term Outcomes After Hip Arthroscopy,” which appears in the March 31, 2021 edition of Arthroscopy.

The research team enrolled a total of 173 patients from a consecutive series who had met the inclusion criteria of:

• 18 years of age,
• Tönnis grade 0 or 1 changes,
• radiographic imaging consistent with FAI (femoral acetabular impingement) or labral pathology,
• primary diagnosis of symptomatic FAI for which they underwent primary hip arthroscopy and had a minimum of 2 years of follow-up.

Revision surgeries were excluded.

Co-author Charles Lin, M.D., M.S., a resident in the Department of Orthopedic Surgery at NYU Langone, told OTW, “Determining whether to pursue additional diagnostics or intervention in the early post-operative period can be challenging, so we sought to find a way to help inform this decision.”

The team prescribed postoperative hip braces for all patients, with each individual being restricted to foot-flat partial weight-bearing for the first month. After that time, the team permitted gradual weightbearing with supervised progressive range of motion and strengthening exercises. Postoperatively, patients were given Percocet 5/325mg 30 days, aspirin 81mg daily 7 days, Celebrex 200mg daily 14 days, and Keflex daily four times daily for three days.

Unhappy patient? You’ll probably know at the 6-month mark.

In this study, patients who did not achieve the minimal clinically important difference (8 points in the modified Harris Hip Score) by 6 months, had significantly lower modified Harris Hip Scores at 1 year and 2 years compared with those who did. And, only 52% of patients who did not achieve minimal clinically important difference by 6 months managed to achieve minimal clinically important difference by 2 years (vs 98% for those that did) and only 24% achieved the patient acceptable symptomatic state by 2 years (vs 88% that did).

Dr. Lin summarized the study’s results to OTW: “Our most important result from this study was that 6 month improvements in the modified Harris Hip Score are predictive of whether patients will achieve the patient acceptable symptomatic state at 2 years. Further studies will examine if these 8 month improvements could be predictive of longer-term outcomes and whether other hip-related patient reported outcomes can be utilized in a similar manner.”