ePoster #729 - ISHA Annual Scientific Meeting 2016
How Are We Using Patient Reported Outcomes In Patients With Fai: Which Score Is Best?
Eric Makhni, MD, Chicago, IL UNITED STATES
Benjamin Kuhns, MD, Chicago, IL UNITED STATES
Jennifer Alter, BS, Chicago, IL UNITED STATES
Joshua David Harris, MD, Houston, TX UNITED STATES
Jaskarndip Chahal, MD, Chicago UNITED STATES
Shane J. Nho, MD, MS, Chicago, IL UNITED STATES
Gift C. Ukwuani, MD, Chicago, IL UNITED STATES
Rush University Medical Center, Chicago, IL, UNITED STATES
FDA Status Cleared
Summary: A correlation of patient reported outcomes (PRO) to benchmark postoperative pain and satisfaction scores
Reporting of patient reported outcomes (PRO) has become increasingly emphasized as a means of judging treatment efficacy and value. The goal of this study was to correlate two commonly used PRO for femoracetabular impingement (FAI) – the modified Harris Hip Score (mHHS) and the Hip Outcome Score (HOS) – with benchmark outcomes of pain and satisfaction following surgery. This has not been previously reported in the literature. Our hypothesis was that the mHHS – which is more focused on activities of daily living – would be more highly correlated with pain and satisfaction in older patients, while the HOS (and specifically Sports Subscale – SS) would be more highly correlated to pain and satisfaction scores in younger patients.
All patients with at least two years follow-up following hip arthroscopy for FAI at our institution from 1/1/2012-1/1/2014 were included for review. The primary PRO collected were the HOS-ADL, HOS-SS, and mHHS. Benchmark subjective outcomes included VAS pain and satisfaction scores. The correlation between PRO scores and VAS pain and satisfaction scores were calculated using a bivariate analysis according to patient age.
Of the 489 patients in the registry, a total of 397 patients reported two-year follow-up data (81%). The average age was 33.7, with quartiles identified as 14.9-23.8, 24.2-33.4, 33.5-42.2, and >42.3 years-23, 24-33. Among all patients, the average postoperative HOS-ADL scores improved from 66.5 to 85.8 (p<0.001), HOS-SS scores improved from 43.7 to 72.1 (p<0.001), and mHHS scores improved from 58.0 to 76.4 (p<0.001). The hypothesis was confirmed as younger patients (first two quartiles; r2=0.66) demonstrated increased correlation between satisfaction scores and HOS-SS scores compared to older patients (r2=0.5 for third quartile and r2=0.35 for fourth quartile). Among all patients, however, all PRO scores were highly correlated with each other as well as the benchmark outcomes (p<0.0001). The HOS-ADL was most highly correlated with the mHHS (r2=0.74) and HOS-SS scores (r2=0.69), and less correlated with postoperative pain (r2=0.5), pain improvement (r2=0.63), and satisfaction (r2=0.56). Satisfaction with surgery was most highly correlated to the HOS-SS (r2=0.66) and least correlated with the mHHS (r2=0.57). Two year pain and pain improvement was most correlated with mHHS (r2=0.57; r2=0.41) and least correlated with HOS-SS (r2=0.45; r2=0.34).
In younger patients, patient satisfaction is more highly correlated with sport-related activity in the HOS-SS than with the scores that are focused on activities of daily living (mHHS or HOS-ADL). This confirms the study hypothesis. Among all patients, all PRO were correlated with pain and satisfaction following surgery, however.