ePoster #104 - ISHA Annual Scientific Meeting 2016
Patient Reported Outcomes After Combined Hip Arthroscopy And Peri-Acetabular Osteotomy
Raymond James Kenney, MD, Rochester, NY UNITED STATES
Sean M. Childs, MD, Rochester, NY UNITED STATES
Kelly Lynne Adler, MEd, ATC, Pittsford, NY UNITED STATES
Christopher Cook, MD, Rochester, NY UNITED STATES
Brian D. Giordano, MD, Rochester, NY UNITED STATES
University of Rochester Medical Center, Rochester, NY, UNITED STATES
FDA Status Not Applicable
Summary: The purpose of this study was to review prospectively collected patient reported outcomes data in patients who have undergone combined Hip Arthroscopy and PAO at a high volume hip preservation center.
Background: Uncorrected symptomatic acetabular dysplasia may increase the risk of functional impairment and degenerative joint disease. Previous studies have linked acetabular dysplasia to premature osteoarthritis. Patient reported outcomes (PRO) data using validated scores has been reported for both arthroscopic and open hip preservation surgery, but to date, there have been few publications that have reported prospectively collected data for patients undergoing combined hip preservation surgery.
Purpose: The purpose of this study was to review prospectively collected PRO data in patients who have undergone combined Hip Arthroscopy and PAO at a high volume hip preservation center.
Methods: Prospectively collected PRO data was reviewed for 68 consecutive patients enrolled in an IRB approved study who underwent combined Hip Arthroscopy and PAO at a single academic medical center from August 2012 through February 2016. 24 patients were identified who had prospectively completed pre-operative PRO data and had a minimum of 12 months follow-up. Questionnaires were administered to patients pre-operative, 3 months, 6 months, 12 months, 18 months and 24 months post-operative. Questionnaires were composed of validated PRO scores: modified Harris Hip Score (mHHS), Hip Outcome Score (HOS) both Activities of Daily Living (ADL) and Sports subscales, Non-arthritic Hip Score (NAHS) and Pain Visual Analog Scale (VAS).
Results: Prospectively collected data was reviewed for 24 patients who completed the mHHS, HOS ADL, HOS Sports, NAHS, Pain VAS questionnaires. Average age at the time of surgery was 31 years old; range 15-51 years old. 4 patients (17%) were male and 20 patients (83%) were female. Average follow-up was 17.8 months; 7 patients at 12 months follow-up, 11 patients at 18 months follow-up and 6 patients at 24 months follow-up. PRO data was reported as averages with 95% confidence intervals in parentheses at pre-operative, 3, 6, 12, 18 and 24 months post-operatively. mHHS: 48.3 (5.6), 52.6 (8.3), 68.0 (8.0), 71.6 (9.4), 73.5 (9.9), 70.3 (18.2). HOS ADL: 58.3 (6.5), 65.7 (9.0), 77.4 (8.6), 83.6 (9.8), 84.3 (9.4), 85.1 (18.7). HOS Sports: 43.6 (8.7), 30.0 (12.4), 62.3 (12.3), 74.4 (13.1), 76.1 (14.0), 76.1 (15.9). NAHS: 55.9 (6.2), 69.2 (6.0), 75.9 (8.1), 82.1 (9.4), 84.2 (8.7), 79.4 (16.3). Pain VAS: 5.6 (0.9), 2.0 (1.0), 1.9 (0.9), 2.1 (1.3), 1.7 (0.9), 1.0 (1.2).
Conclusion: NAHS and Pain VAS showed significant improvement for patients at 3 months post-operatively compared to pre-operative PRO measures. The mHHS, HOS ADL, NAHS and Pain VAS were significantly improved at 6 months compared to pre-operative PRO measures, and HOS Sports approached significance. There was significant improvement in all PRO measures at 12 months and 18 months post-operatively when compared to pre-operative measures. 24 months post-operative HOS Sports, NAHS and Pain VAS were significantly improved when compared to pre-operative measures while the mHHS and HOS ADL approached significance; likely limited by the decreased number of PRO measures captured at the 24 month time interval. Prospectively collected PRO data in a series of patients after combined Hip Arthroscopy and PAO demonstrated significant improvement at 6 months post-operative and beyond when compared to PRO measures collected pre-operatively.