Pierannunzii Luca, Di Benedetto Paolo, Carulli Christian, Fiorentino Gennaro, Munegato Daniele, Panascì Manlio, Potestio Domenico, Randelli Filippo, Della Rocca Federico, Rosolen Valentina, Giangreco Manuela, Santori Nicola
1 Gaetano Pini Orthopaedic Institute, Milan, Italy.
2 Clinica Ortopedica, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy.
Hip Int. 2019 May;29(3):303-309. doi: 10.1177/1120700018786025. Epub 2018 Jul 10.
To build a post-arthroscopy outcome-predictive score (POPS) associated with the likelihood of lasting benefit after arthroscopic treatment of femoroacetabular impingement (FAI) and based solely on unambiguous preoperative information.
A population of 220 FAI patients, operated on with standard techniques by orthopaedic surgeons trained in hip arthroscopy in 6 different centres, was evaluated physically or by telephone interview 2 to 5 years after surgery. The criteria of successful mid-term outcome (SMO) were agreed upon by all authors. A multivariate logistic regression, adjusted for patient's age and centre, was applied to predict SMO. In the model, the variables associated with the outcome were included and the relative ORs (odds ratios) were used to compute the FAI-POPS (FAI - post-arthroscopy outcome-predictive score). A ROC (receiver operating characteristic) curve was plotted and the optimum cut-off was calculated.
155 patients out of 220 showed a successful mid-term outcome. The optimum cut-off of FAI-POPS was calculated to be 6.3 and with this threshold it proved a sensitivity of 0.66 and a specificity of 0.69, a positive predictive value of 0.84 and a negative predictive value of 0.46.
The standard arthroscopic treatment of FAI resulted in satisfactory persistent symptom relief for about 70% of patients. No or minimal osteoarthritis, short time elapsed from the appearance of symptoms and high preoperative modified Harris Hip Score are independent predictive factors of SMO. The FAI-POPS is obtained as sum of 3 odds ratios corresponding to the above prognostic factors and is a useful predictor of mid-term outcome after conventional arthroscopic FAI treatment.
构建一种关节镜检查后结果预测评分（POPS），该评分与股骨髋臼撞击症（FAI）关节镜治疗后持久获益的可能性相关，且仅基于明确的术前信息。
对220例FAI患者进行研究，这些患者由6个不同中心接受髋关节镜培训的骨科医生采用标准技术进行手术，术后2至5年通过体格检查或电话访谈进行评估。所有作者就中期成功结果（SMO）的标准达成一致。应用多因素逻辑回归分析，对患者年龄和中心进行校正，以预测SMO。在模型中纳入与结果相关的变量，并使用相对比值比（OR）来计算FAI-POPS（FAI - 关节镜检查后结果预测评分）。绘制ROC（受试者工作特征）曲线并计算最佳截断值。
220例患者中有155例显示中期成功结果。计算得出FAI-POPS的最佳截断值为6.3，以此阈值显示其敏感性为0.66，特异性为0.69，阳性预测值为0.84，阴性预测值为0.46。
FAI的标准关节镜治疗使约70%的患者症状得到持久缓解且效果满意。无或仅有轻微骨关节炎、症状出现后时间较短以及术前改良Harris髋关节评分较高是SMO的独立预测因素。FAI-POPS是上述三个预后因素对应的比值比之和，是传统关节镜下FAI治疗后中期结果的有用预测指标。
