Paper #73 - ISHA Annual Scientific Meeting 2016

Do Females Report Functional Limitations Following Revision Arthroscopy?

Maureen Dwyer, PhD, ATC, Newton, MA UNITED STATES
Jo Ann Lee, NP, Newton, MA UNITED STATES
Joseph C. McCarthy, MD, NEWTON, MA UNITED STATES

Newton Wellesley Hospital, Newton, MA, UNITED STATES

FDA Status Not Applicable

Summary: Females undergoing revision arthroscopy report limitations in activities that require more motion and endurance of the hip at 2-5 year follow-up.

Abstract:
Objectives
Female sex has been identified as an important factor in determining outcomes from hip arthroscopy, with reduced outcome scores reported for females following surgery. However, the effect of revision procedures on clinical outcomes for female patients is unknown. In addition, no study has reported the specific functional limitations reported by patients following hip arthroscopy. We compared mid-term outcomes between females who underwent primary and revision hip arthroscopy and identified specific limitations in function reported using the IHOT-33.

Methods
Female patients who had undergone arthroscopic treatment for labrochondral injuries at least 2 years prior to evaluation were contacted to participate in this study. Clinical outcomes were assessed using the IHOT-33. To identify the presence of specific functional limitations, a separate score for each of the individual 33 questions was calculated out of 100 possible points. In addition, total score on the IHOT-33 was calculated. Total score and scores for each of the 33 individual questions were compared between groups of females who underwent primary and revision procedures using separate independent samples t-tests.

Results
One hundred female patients were contacted to participate in this study. Completed IHOT-33 data was available for 55 females, with an average age of 38.6±12.7 years and an average time to follow-up of 2.8±0.9 years. There were 42 primary and 11 revision procedures. The two groups did not differ in terms of age (p=0.67) or time to follow-up (p=0.8). Total score on the IHOT-33 did not differ for females between primary and revision procedures (66.2±24.6 vs. 52.5±30.9; p=0.13). However, females who underwent revision procedures reported more trouble standing on their feet for long periods of time (p=0.038), more difficulty getting up and down off the ground (p=0.045), more difficulty walking on uneven surfaces (p=0.015), more trouble stepping over obstacles (p=0.006), more trouble rising from a sitting position (p=0.047), more discomfort with taking long strides (p=0.028), more difficulty putting on/taking off socks and shoes (p=0.032), and more trouble with sexual activity because of their hip (p=0.017) when compared to females who underwent primary procedures.

Conclusions
Despite the lack of differences in overall score on the IHOT-33 between primary and revision procedures for females who underwent hip arthroscopy, our findings revealed the presence of limitations in specific functions for females following revision arthroscopy. Increased difficulty existed during those activities that required more motion and endurance of the hip. While reporting overall scores on outcome measures is preferred, our results demonstrated that using this method may result in missing important functional differences between groups of patients.