Uppstrom Tyler J, Sullivan Spencer W, Burger Joost A, Ranawat Anil S, Kelly Bryan T, Nwachukwu Benedict U
Sports Medicine Institute, Hospital for Special Surgery, New York, New York, USA.
Orthop J Sports Med. 2021 Apr 7;9(4):23259671211007740. doi: 10.1177/23259671211007740. eCollection 2021 Apr.
Open repair for gluteus medius and minimus tears is a common surgical treatment for patients with lateral hip pain associated with abductor tears; however, clinically meaningful outcomes have not been described after open surgical treatment.
To define the minimal clinically important difference (MCID) in patient-reported outcome measures (PROMs) in patients undergoing open gluteus medius or minimus repair, and to identify preoperative patient characteristics predictive of achieving MCID postoperatively.
Case series; Level of evidence, 4.
A retrospective review of prospectively collected data from a consecutive series of patients undergoing open abductor repair between July 2010 and April 2019 was conducted. Perioperative patient data collected included patient characteristics and preoperative and postoperative modified Harris Hip Score (mHHS) and International Hip Outcome Tool (iHOT-33) score. Paired tests were utilized to compare preoperative and postoperative PROMs and MCID was calculated for both PROMs. Multivariate logistical regression analysis was used to assess the association between preoperative variables and the likelihood for achieving MCID.
A total of 47 patients were included in the study. The majority of patients were female (78.7%), with an average age of 63 ± 10.7 years. The average follow-up for both the mHHS and the iHOT-33 surveys was 37.8 ± 27.9 months (range, 10-102 months). Patients demonstrated statistically significant improvements on the mHHS and iHOT-33 postoperatively ( < .001 for both). The MCIDs of mHHS and iHOT-33 were calculated to be 9.9 and 14.3, respectively. Overall, 82.9% of patients achieved MCID for mHHS and 84.1% of patients achieved MCID for iHOT-33 postoperatively. Multivariate logistical analysis demonstrated younger patients were less likely to achieve MCID for both outcome measures. Four patients (8.5%) suffered postoperative complications after open repair.
This study defined MCID for mHHS and iHOT-33 for patients undergoing open repair of hip abductor tears, with a large percentage of patients (>80%) achieving meaningful outcomes for both outcome measures. There was a low complication rate. Younger patients were less likely to achieve MCID compared with older patients.
臀中肌和臀小肌撕裂的开放修复术是治疗伴有外展肌撕裂的髋关节外侧疼痛患者的常见手术治疗方法；然而，开放手术治疗后的临床有意义的结果尚未见报道。
确定接受臀中肌或臀小肌开放修复术患者的患者报告结局指标（PROMs）中的最小临床重要差异（MCID），并确定术前患者特征对术后达到MCID的预测作用。
病例系列；证据等级，4级。
对2010年7月至2019年4月连续接受开放外展肌修复术的一系列患者前瞻性收集的数据进行回顾性分析。收集的围手术期患者数据包括患者特征以及术前和术后改良Harris髋关节评分（mHHS）和国际髋关节结局工具（iHOT-33）评分。采用配对t检验比较术前和术后的PROMs，并计算两种PROMs的MCID。多因素logistic回归分析用于评估术前变量与达到MCID可能性之间的关联。
本研究共纳入47例患者。大多数患者为女性（78.7%），平均年龄63±10.7岁。mHHS和iHOT-33调查的平均随访时间为37.8±27.9个月（范围10-102个月）。患者术后mHHS和iHOT-33均有统计学意义的改善（两者P<0.001）。mHHS和iHOT-33的MCID分别计算为9.9和14.3。总体而言，82.9%的患者术后mHHS达到MCID，84.1%的患者术后iHOT-33达到MCID。多因素logistic分析表明，年轻患者在两种结局指标上达到MCID的可能性较小。4例患者（8.5%）开放修复术后出现术后并发症。
本研究确定了髋关节外展肌撕裂开放修复患者mHHS和iHOT-33的MCID，超过80%的患者在两种结局指标上都取得了有意义的结果。并发症发生率较低。与老年患者相比，年轻患者达到MCID的可能性较小。
