ePoster #108 - ISHA Annual Scientific Meeting 2016

Multi-Centered Comparison Of Patient Reported Outcomes After Hip Arthroscopy Alone Versus Combined Hip Arthroscopy And Peri-Acetabular Osteotomy In Patients With Acetabular Dysplasia

Benjamin G. Domb, MD, Chicago, IL UNITED STATES
Raymond James Kenney, MD, Rochester, NY UNITED STATES
Christopher Cook, MD, Rochester, NY UNITED STATES
Justin LaReau, MD, Chicago, IL UNITED STATES
Sean M. Childs, MD, Rochester, NY UNITED STATES
Edwin Chaharbakhshi, BS, Hinsdale, IL 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 compare prospectively collected patient reported outcomes data in patients undergoing Hip Arthroscopy alone versus combined Hip Arthroscopy and Peri-acetubular Osteotomy.

Abstract:
Purpose: The purpose of this study was to compare prospectively collected patient reported outcomes (PRO) data in patients undergoing Hip Arthroscopy alone versus combined Hip Arthroscopy and Peri-acetubular Osteotomy (HA/PAO). Methods: Prospectively collected PRO data was reviewed in patients enrolled in IRB approved studies at two high volume hip preservation centers who underwent either Hip Arthroscopy alone or combined HA/PAO. Patients were included who had a lateral center edge angle <25 degrees, completed pre-operative and a minimum of 1 year post-operative PRO data. Questionnaires were administered to patients at intervals including pre-operative, 3 months, 1 year and 2 years post-operative. Questionnaires were composed of validated PRO scores: modified Harris Hip Score (mHHS), Hip Outcome Score (HOS) 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 91 patients who underwent Hip Arthroscopy and 34 patients who underwent HA/PAO. Average age at the time of surgery was 32 years old (range 14-62) for arthroscopy and 31 years old (range 15-51) for combined surgery. Hip Arthroscopy patients were 35% male and 65% female. HA/PAO patients were 15% male and 85% female. PRO data for Hip Arthroscopy, reported as averages with 95% confidence intervals in parentheses at pre-operative, 3 months, 1 year and 2 years post-operatively. mHHS: 66.3 (3.1), 83.8 (3.5), 84.3 (4.1), 84.4 (3.4). HOS ADL: 70.1 (4.0), 85.3 (3.2), 87.1 (4.2), 87.4 (4.0). HOS Sports: 47.3 (4.6), 64.7 (6.6), 73.7 (8.1), 75.2 (5.9). NAHS: 65.5 (3.7), 80.1 (3.3), 83.8 (4.5), 83.8 (3.9). Pain VAS: 5.4 (0.5), 2.6 (0.5), 2.5 (0.6), 2.6 (0.6). PRO data for HA/PAO, reported as averages with 95% confidence intervals in parentheses at pre-operative, 3 months, 1 year and 2 years post-operatively. mHHS: 51.1 (4.6), 58.7 (7.9), 71.7 (7.3), 74.7 (13.1). HOS ADL: 58.3 (6.5), 65.7 (9.0), 83.6 (9.8), 85.1 (18.7). HOS Sports: 41.7 (7.2), 38.0 (11.7), 72.5 (11.5), 79.3 (11.9). NAHS: 56.7 (5.2), 71.6 (5.3), 80.2 (7.7), 83.4 (11.8). Pain VAS: 5.3 (0.9), 1.9 (0.8), 2.2 (1.0), 1.0 (0.9). Conclusion: Both cohorts had significant improvement in all PRO measures at 1 and 2 years when compared to pre-operative PRO measures. HA/PAO patients had significantly lower mHHS and HOS ADL pre-operatively; NAHS approached significance. HOS Sports and Pain VAS had no significant pre-operative differences between groups. At 3 months, the HA/PAO patients had significantly lower mHHS, HOS ADL and HOS Sports, while again NAHS approached significance. There was no significant difference in Pain VAS at 3 months. Only the mHHS remained significantly lower for the HA/PAO patients at 1 year. At 2 years, only Pain VAS showed significantly better pain scores for HA/PAO patients, although lacking clinical significance. All other PRO measures showed no significant difference at 2 years. Patients who underwent HA/PAO had significantly lower pre-operative and early post-operative PRO measures. HA/PAO patients, however, reached similar values for PRO measures by 1 year; only the mHHS remained lower. At 2 years, neither group showed statistical or clinical difference in PRO measures.