Rosinsky Philip J, Kyin Cynthia, Maldonado David R, Shapira Jacob, Meghpara Mitchell B, Ankem Hari K, Lall Ajay C, Domb Benjamin G
American Hip Institute Research Foundation, Chicago, Illinois, U.S.A.
Kerlan-Jobe Institute, Los Angeles, California, U.S.A.
Arthroscopy. 2021 Oct;37(10):3113-3121. doi: 10.1016/j.arthro.2021.03.059. Epub 2021 Apr 15.
The purpose of this study was to improve the interpretability of the Nonarthritic Hip Score (NAHS) by determining the minimal clinically important difference (MCID), patient acceptable symptomatic state (PASS), and substantial clinical benefit (SCB) after hip arthroscopy for femoroacetabular impingement. The secondary aim was to identify variables associated with achievement of the thresholds.
Patients who underwent hip arthroscopy for femoroacetabular impingement and completed postoperative questionnaires between August 2019 and March 2020 were included. Patients were excluded if they underwent previous ipsilateral hip surgery, underwent gluteus medius repair, or had a previous hip condition. The MCID, PASS, and SCB thresholds were calculated for the NAHS at minimum 1-, 2-, and 5-year follow-up. Distribution- and anchor-based methods with receiver operating characteristic analysis were used to determine the thresholds. Multivariate logistic regression was performed to determine predictors of achieving the MCID and PASS.
The study included 343 hips with an average follow-up period of 48 months. On the basis of the distribution-based approach, the MCID was 8.7 using a method in which the standard deviation of the baseline score was divided by 2. By use of a method in which the standard deviation of the change score was divided by 2, MCID scores of 9.1, 8.3, and 12.6 resulted at a minimum of 1, 2, and 5 years, respectively. The PASS thresholds for these time points were 81.9, 85.6, and 81.9. The absolute SCB thresholds were 91.9, 94.4, and 93.1 and the change score thresholds were 30.6, 24.4, and 29.3 for a minimum of 1, 2, and 5 years, respectively. The preoperative NAHS was positively associated with achievement of the PASS and inversely related to achievement of the MCID.
This study provides important clinical thresholds for the NAHS. These thresholds were determined for minimum 1-, 2-, and 5-year time points. The MCID was determined as 8.7, the PASS ranged between 81.9 and 85.6, and the absolute SCB value ranged from 91.9 to 94.4. The preoperative NAHS was found to be positively associated with achievement of the PASS and inversely related to achievement of the MCID.
Level IV, retrospective case series.
本研究的目的是通过确定髋关节镜治疗股骨髋臼撞击症后的最小临床重要差异（MCID）、患者可接受症状状态（PASS）和显著临床获益（SCB），来提高非关节炎性髋关节评分（NAHS）的可解释性。次要目的是确定与达到这些阈值相关的变量。
纳入2019年8月至2020年3月期间因股骨髋臼撞击症接受髋关节镜手术并完成术后问卷的患者。如果患者既往同侧髋关节手术、接受臀中肌修复或有既往髋关节疾病，则排除在外。在至少1年、2年和5年的随访中计算NAHS的MCID、PASS和SCB阈值。采用基于分布和锚定的方法并结合受试者工作特征分析来确定阈值。进行多因素逻辑回归以确定达到MCID和PASS的预测因素。
该研究纳入了343例髋关节，平均随访期为48个月。基于分布法，使用基线评分标准差除以2的方法，MCID为8.7。使用变化评分标准差除以2的方法，在至少1年、2年和5年时，MCID评分分别为9.1、8.3和12.6。这些时间点的PASS阈值分别为81.9、85.6和81.9。至少1年、2年和5年时的绝对SCB阈值分别为91.9、94.4和93.1，变化评分阈值分别为30.6、24.4和29.3。术前NAHS与达到PASS呈正相关，与达到MCID呈负相关。
本研究为NAHS提供了重要的临床阈值。这些阈值是在至少1年、2年和5年的时间点确定的。MCID确定为8.7，PASS在81.9至85.6之间，绝对SCB值在91.9至94.4之间。发现术前NAHS与达到PASS呈正相关，与达到MCID呈负相关。
IV级，回顾性病例系列。
