NYU Langone Orthopedic Hospital, New York, York, U.S.A..
NYU Langone Orthopedic Hospital, New York, York, U.S.A.
Arthroscopy. 2021 Oct;37(10):3081-3087. doi: 10.1016/j.arthro.2021.03.046. Epub 2021 Apr 1.
To determine whether early patient-reported outcome improvements in the 6 months after surgery are predictive of achieving a patient acceptable symptomatic state (PASS) at 2 years.
A prospectively collected database was retrospectively reviewed. Inclusion criteria included patients ≥18 years of age, Tönnis grade 0 or 1 changes, radiographic imaging consistent with femoroacetabular impingement or labral pathology, a primary diagnosis of symptomatic femoroacetabular impingement for which they underwent primary hip arthroscopy, and baseline, 6-month, and 2-year modified Harris Hip Score (mHHS) scores. Revision cases were excluded. Receiver operating characteristic curve analysis was conducted to determine whether 6-month change in mHHS was a predictor for achieving PASS at 2 years.
There were 173 patients (mean age: 39.8, 61.8% female) included within the study. Patients who do not achieve the minimal clinically important difference (MCID), defined as a change of 8 points in mHHS, by 6 months (n = 21) tended to have significantly lower mHHS scores at 1 year and 2 years compared with those who did (n = 152). Only 52% of patients who did not achieve MCID by 6 months achieved MCID by 2 years (vs 98% for those that did) and only 24% achieved PASS by 2 years (vs 88% that did). Using the MCID as a cutoff for improvement in mHHS at 6 months results in a 96% sensitivity but 47% specificity for predicting PASS achievement at 2 years. Using 24 points of improvement in mHHS as a cutoff at 6 months improves sensitivity and specificity to 81% and 80%, respectively.
Early improvement in mHHS scores is associated with 2-year outcomes. Patients who do not achieve MCID within 6 months of surgery have a high rate of not achieving PASS at 2 years.
IV, case series study.
确定术后 6 个月内患者报告结局的早期改善是否可预测 2 年时达到患者可接受的症状状态（PASS）。
回顾性分析前瞻性收集的数据库。纳入标准包括年龄≥18 岁、Tönnis 分级 0 或 1 级改变、影像学表现符合股骨髋臼撞击症或盂唇病变、原发性症状性股骨髋臼撞击症行初次髋关节镜手术、以及基线、6 个月和 2 年改良 Harris 髋关节评分（mHHS）。排除翻修病例。进行受试者工作特征曲线分析，以确定 6 个月时 mHHS 的变化是否可预测 2 年时达到 PASS。
本研究共纳入 173 例患者（平均年龄：39.8 岁，61.8%为女性）。未达到最小临床重要差异（MCID）的患者（定义为 mHHS 变化 8 分），在 1 年和 2 年时 mHHS 评分明显低于达到 MCID 的患者（n=152）。在 6 个月时未达到 MCID 的患者中，仅有 52%在 2 年时达到 MCID（而达到 MCID 的患者为 98%），仅有 24%在 2 年时达到 PASS（而达到 MCID 的患者为 88%）。将 6 个月时 mHHS 改善作为 MCID 的截定点，可使预测 2 年时达到 PASS 的敏感度达到 96%，但特异性为 47%。将 6 个月时 mHHS 改善 24 分作为截定点，可使敏感度和特异性分别提高至 81%和 80%。
mHHS 评分的早期改善与 2 年的结果相关。术后 6 个月内未达到 MCID 的患者在 2 年内达到 PASS 的比例较高。
IV，病例系列研究。
