髋关节镜治疗股骨髋臼撞击综合征后有多少患者达到可接受的症状状态？一项横断面研究，包括髋关节骨关节炎和髋关节功能评分（HAGOS）及33项国际髋关节Outcome Tool（iHOT-33）的患者可接受症状状态（PASS）临界值。
How Many Patients Achieve an Acceptable Symptom State After Hip Arthroscopy for Femoroacetabular Impingement Syndrome? A Cross-sectional Study Including PASS Cutoff Values for the HAGOS and iHOT-33.
作者信息
Ishøi Lasse, Thorborg Kristian, Ørum Marie G, Kemp Joanne L, Reiman Michael P, Hölmich Per
机构信息
Sports Orthopedic Research Center-Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark.
La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
出版信息
Orthop J Sports Med. 2021 Apr 9;9(4):2325967121995267. doi: 10.1177/2325967121995267. eCollection 2021 Apr.
BACKGROUND
Hip arthroscopy is a viable treatment for femoroacetabular impingement syndrome (FAIS). Clinically relevant improvements in hip function and pain after surgery are often reported, but it is less clear how many patients achieve an acceptable symptom state (Patient Acceptable Symptom State [PASS]).
PURPOSE
To investigate the proportion of patients who achieved a PASS 12 to 24 months after hip arthroscopy and to determine the cutoff scores of the 2 recommended and valid patient-reported outcome measures (the subscales of the Copenhagen Hip and Groin Outcome Score [HAGOS] and the International Hip Outcome Tool-33 [iHOT-33]) for which patients are most likely to achieve PASS.
STUDY DESIGN
Cohort study; Level of evidence, 3.
METHODS
Eligible study patients were identified in the Danish Hip Arthroscopy Registry. An electronic questionnaire was used to collect data on PASS, HAGOS, and iHOT-33 12 to 24 months after surgery. PASS was measured using an anchor question. Receiver operating characteristic curve analyses were applied to identify the PASS cutoff values of HAGOS and iHOT-33 scores.
RESULTS
A total of 137 individuals (mean age at surgery, 35.4 ± 9.4 years) were included in the study at a mean follow-up of 18.5 ± 3.2 months after surgery. At follow-up, 64 individuals (46.7%; 95% CI, 38.6-55.1) reported PASS. Higher HAGOS and iHOT-33 values were observed for participants who reported PASS compared with those who did not report PASS (Cohen ≥ 1.06; < .001). Cutoff scores for HAGOS subscales (42.5-82.5) and iHOT-33 (67.00) showed excellent to outstanding discriminative ability in predicting PASS (area under the curve, 0.82-0.92).
CONCLUSION
In total, 46% of individuals having hip arthroscopy for FAIS achieved PASS at 12 to 24 months of follow-up. Patients who achieved PASS had statistically significant and substantially better self-reported hip function compared with those who did not achieve PASS. Cutoff values at HAGOS subscales and iHOT-33 showed excellent to outstanding discriminative ability in predicting patients with PASS.
背景
髋关节镜检查是治疗股骨髋臼撞击综合征（FAIS）的一种可行方法。临床上常报告手术后髋关节功能和疼痛有相关改善，但尚不清楚有多少患者达到可接受的症状状态（患者可接受症状状态[PASS]）。
目的
调查髋关节镜检查术后12至24个月达到PASS的患者比例，并确定两种推荐且有效的患者报告结局指标（哥本哈根髋关节与腹股沟结局评分[HAGOS]的子量表和国际髋关节结局工具-33[iHOT-33]）的临界值，患者最有可能据此达到PASS。
研究设计
队列研究；证据等级，3级。
方法
在丹麦髋关节镜检查注册中心确定符合条件的研究患者。使用电子问卷收集术后12至24个月有关PASS、HAGOS和iHOT-33的数据。使用一个锚定问题来测量PASS。应用受试者工作特征曲线分析来确定HAGOS和iHOT-33评分的PASS临界值。
结果
共有137名个体（手术时平均年龄35.4±9.4岁）纳入研究，术后平均随访18.5±3.2个月。随访时，64名个体（46.7%；95%CI，38.6 - 55.1）报告达到PASS。与未报告达到PASS的参与者相比，报告达到PASS的参与者的HAGOS和iHOT-33值更高（Cohen≥1.06；P <.001）。HAGOS子量表（42.5 - 82.5）和iHOT-33（67.00）的临界值在预测PASS方面显示出优异至出色的判别能力（曲线下面积，0.82 - 0.92）。
结论
总体而言，因FAIS接受髋关节镜检查的个体中，46%在随访12至24个月时达到PASS。与未达到PASS的患者相比，达到PASS的患者自我报告的髋关节功能在统计学上有显著改善且明显更好。HAGOS子量表和iHOT-33的临界值在预测达到PASS的患者方面显示出优异至出色的判别能力。
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