Lawton Cort D, Sullivan Spencer W, Hancock Kyle J, Burger Joost A, Nawabi Danyal H, Kelly Bryan T, Ranawat Anil S, Nwachukwu Benedict U
Sports Medicine Institute, Hospital for Special Surgery, New York, NY 10021, USA.
J Hip Preserv Surg. 2021 Aug 19;8(4):348-353. doi: 10.1093/jhps/hnab068. eCollection 2021 Dec.
There is a paucity of literature on patient-reported outcome measures (PROMs) following proximal hamstring repair beyond return to play, patient satisfaction and pain improvement. The minimal clinically important difference (MCID) defines the minimum degree of quantifiable improvement that a patient can perceive, but the MCID and predictors of this measure have not been defined for this patient population. This study aimed to define the MCID and determine the efficacy of open proximal hamstring repair through achievement of MCID and identify characteristics predictive of achieving MCID. A retrospective cohort review of an institutional hip registry was conducted, analyzing the modified Harris Hip Score (mHHS) and International Hip Outcome Tool (iHOT-33). MCID was calculated using a distribution-based method. Demographic and clinical variables predictive of achieving MCID were analyzed using univariable and multivariate logistic regression analyses. Thirty-nine patients who underwent open proximal hamstring repair were included. The mean patient age was 48.5 ± 12.4 years, with a mean follow-up of 37.1 ± 28 months. The MCID was determined for each PROM (mHHS-11.8; iHOT-33-12.6). A high percentage of patients achieved MCID for both PROMs (mHHS-85.7%; iHOT-33-91.4%). Univariate logistical regression demonstrated increased age ( = 0.163), increased body mass index (BMI; = 0.072), requirement for inpatient admission ( = 0.088) and pre-operative iHOT-33 ( = 0.104) trended towards clinically significant predictors of not achieving MCID. A high percentage of patients achieved MCID while age, BMI, inpatient admission and pre-operative iHOT-33 appear to influence the achievement of clinically significant outcome in patients undergoing open proximal hamstring repair.
除了恢复运动、患者满意度和疼痛改善之外,关于腘绳肌近端修复术后患者报告结局量表(PROMs)的文献较少。最小临床重要差异(MCID)定义了患者能够感知到的可量化改善的最小程度,但该患者群体的MCID及其预测因素尚未明确。本研究旨在明确MCID,并通过实现MCID来确定开放性腘绳肌近端修复术的疗效,同时识别预测实现MCID的特征。对一个机构性髋关节登记处进行了回顾性队列研究,分析改良Harris髋关节评分(mHHS)和国际髋关节结局工具(iHOT-33)。使用基于分布的方法计算MCID。采用单变量和多变量逻辑回归分析来分析预测实现MCID的人口统计学和临床变量。纳入了39例行开放性腘绳肌近端修复术的患者。患者平均年龄为48.5±12.4岁,平均随访时间为37.1±28个月。确定了每个PROM的MCID(mHHS为11.8;iHOT-33为12.6)。两个PROM中都有很高比例的患者实现了MCID(mHHS为85.7%;iHOT-33为91.4%)。单变量逻辑回归显示年龄增加(P=0.163)、体重指数(BMI)增加(P=0.072)、需要住院治疗(P=0.088)和术前iHOT-33(P=0.104)倾向于成为未实现MCID的具有临床意义的预测因素。在接受开放性腘绳肌近端修复术的患者中,虽然有很高比例的患者实现了MCID,但年龄、BMI、住院治疗和术前iHOT-33似乎会影响具有临床意义的结局的实现。