American Hip Institute Research Foundation, Chicago, IL, USA.
American Hip Institute, Chicago, IL, USA.
Am J Sports Med. 2022 Jul;50(8):2174-2180. doi: 10.1177/03635465221096872. Epub 2022 May 25.
The maximal outcome improvement threshold for willingness to undergo revision hip arthroscopy (MOWT) has not been defined yet.
To determine the percentage MOWT in patients who underwent revision hip arthroscopy and to identify predictors of achieving the MOWT.
Case-control study; Level of evidence, 3.
An anchor question was provided to patients who underwent revision hip arthroscopy between April 2008 and June 2020 who returned for follow-up between August 2019 and June 2021 at one institution. Patients were included if they underwent revision hip arthroscopy, had answered the anchor question, and had baseline and postoperative minimum 1-year follow-up scores for the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), and the visual analog scale (VAS) for pain. Exclusion criteria were Tönnis grade >1, hip dysplasia, previous hip conditions, or unwillingness to participate. Receiver operating characteristic analysis was used to determine the MOWT. Multivariate logistic regression was used to determine intraoperative predictors of achieving the MOWT.
In total, 153 patients (163 hips) were included, with 117 female hips (71.8%), a mean patient age of 34.3 ± 12.4 years, and an average follow-up time of 61.6 ± 42.7 months. It was determined that 77.3% of the patients reported that they would choose to undergo the revision hip arthroscopy again. The MOWT for the mHHS, NAHS, and VAS was 43.1%, 53%, and 33.4%, respectively. The probability of choosing to undergo revision surgery if the MOWT was achieved was 77.5%, 77.6%, and 79.2%, for the mHHS, NAHS, and VAS, respectively. Patients with residual cam-type morphology, which was addressed during the revision, were 2.3 times more likely to achieve the MOWT for the VAS ( = .014).
Patients who improved 43.1%, 53%, and 33.4% of their MOWT for the mHHS, NAHS, and VAS, respectively, were likely to be willing to undergo revision hip arthroscopy again. Moreover, the presence of residual cam-type femoroacetabular impingement morphology before their revision surgery was identified as a predictor to achieve the MOWT for the VAS.
修订髋关节镜检查的最大结果改善阈值（MOWT）尚未确定。
确定接受修订髋关节镜检查的患者的 MOWT 百分比，并确定达到 MOWT 的预测因素。
病例对照研究；证据水平，3 级。
在一家机构，对 2008 年 4 月至 2020 年 6 月间接受修订髋关节镜检查并于 2019 年 8 月至 2021 年 6 月间返回随访的患者提供了一个锚定问题。如果患者接受了修订髋关节镜检查、回答了锚定问题、并且在基线和术后至少 1 年的改良 Harris 髋关节评分（mHHS）、非关节炎髋关节评分（NAHS）和疼痛视觉模拟量表（VAS）有随访评分，则纳入研究。排除标准为 Tönnis 分级>1、髋关节发育不良、先前的髋关节疾病或不愿意参加。使用受试者工作特征分析来确定 MOWT。使用多变量逻辑回归来确定达到 MOWT 的术中预测因素。
共纳入 153 名患者（163 髋），其中 117 髋为女性（71.8%），患者平均年龄为 34.3±12.4 岁，平均随访时间为 61.6±42.7 个月。结果显示，77.3%的患者表示愿意再次接受修订髋关节镜检查。mHHS、NAHS 和 VAS 的 MOWT 分别为 43.1%、53%和 33.4%。如果达到 MOWT，选择再次接受修订手术的概率分别为 mHHS、NAHS 和 VAS 的 77.5%、77.6%和 79.2%。在修订手术中解决了残余凸轮样形态的患者，其 VAS 的 MOWT 达到 2.3 倍（ =.014）。
mHHS、NAHS 和 VAS 的 MOWT 分别改善了 43.1%、53%和 33.4%的患者，更有可能愿意再次接受修订髋关节镜检查。此外，在修订手术前存在残余凸轮样股骨髋臼撞击形态被确定为达到 VAS 的 MOWT 的预测因素。
