American Hip Institute Research Foundation, Chicago, Illinois, USA.
American Hip Institute, Chicago, Illinois, USA.
Am J Sports Med. 2022 Sep;50(11):3009-3018. doi: 10.1177/03635465221114400. Epub 2022 Aug 16.
The minimal clinically important difference (MCID), Patient Acceptable Symptom State (PASS), substantial clinical benefit (SCB), and maximum outcome improvement (MOI) satisfaction threshold for the Hip Outcome Score Sport-Specific Subscale (HOS-SSS) have not been established in athletes undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS).
To determine threshold MCID, PASS, SCB, and MOI satisfaction threshold values for the HOS-SSS in athletes undergoing hip arthroscopy for FAIS at minimum 2-year follow-up.
Cohort study (Diagnosis); Level of evidence, 3.
Anchor questions were administered to recreational, organized amateur, high school, college, and professional athletes who underwent primary hip arthroscopy for FAIS between May 2015 and March 2019. Patients were included if they were younger than 50 years, answered the anchor questions, and had preoperative and minimum 2-year follow-up for the HOS-SSS, modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), and visual analog scale (VAS) for pain. Exclusion criteria were Tönnis grade >1, hip dysplasia (lateral center-edge angle <18°), and previous ipsilateral hip surgery or conditions. Receiver operating characteristic (ROC) analysis was used to determine PASS, SCB, and MOI satisfaction for the HOS-SSS. Two distribution methods were used to calculate MCID for HOS-SSS.
A total of 225 athletes who underwent primary hip arthroscopy met the inclusion criteria. Of those athletes, 200 (88.9%) who had minimum 2-year follow-up and information regarding return to sport (RTS) were included. The cohort included 124 (62.0%) women and 76 (38.0%) men with a mean ± standard deviation age of 29.4 ± 10.4 years, body mass index of 25.6 ± 5.4, and follow-up of 29.5 ± 5.1 months. Athletes experienced significant improvements in HOS-SSS, mHHS, NAHS, and VAS from preoperative to latest postoperative follow-up ( < .001), and mean satisfaction was 8.2. The RTS rate was 83.7%. ROC analysis determined that the PASS, MOI satisfaction threshold, SCB absolute score, SCB change score, and MCID (baseline/change score methods) for the HOS-SSS were 77.0, 44.6%, 92.7, 30.6, and 10.6, respectively, with athletes achieving thresholds at high rates (80.0%, 80.5%, 45.0%, 54.0%, and 79.5%, respectively).
This study identified values for the HOS-SSS that can be used to define clinically meaningful outcomes in athletes after primary hip arthroscopy for FAIS. The PASS, MOI satisfaction threshold, SCB absolute score, SCB change score, and MCID for the HOS-SSS at minimum 2-year follow-up in athletes after primary hip arthroscopy were 77.0, 44.6%, 92.7, 30.6, and 10.6, respectively.
在接受髋关节镜检查治疗股骨髋臼撞击综合征（FAIS）的运动员中，尚未确定髋关节结局评分运动特异性亚量表（HOS-SSS）的最小临床重要差异（MCID）、患者可接受的症状状态（PASS）、实质性临床获益（SCB）和最大结局改善（MOI）满意度阈值。
确定接受髋关节镜检查治疗 FAIS 的运动员在至少 2 年随访时 HOS-SSS 的 MCID、PASS、SCB 和 MOI 满意度阈值。
队列研究（诊断）；证据水平，3 级。
向接受髋关节镜检查治疗 FAIS 的娱乐性、业余组织、高中、大学和职业运动员发放锚定问题问卷。如果患者年龄小于 50 岁，回答了锚定问题，并且在术前和至少 2 年的 HOS-SSS、改良 Harris 髋关节评分（mHHS）、非关节炎髋关节评分（NAHS）和视觉模拟评分（VAS）进行了随访，则纳入研究。排除标准为 Tönnis 分级>1 级、髋关节发育不良（外侧中心边缘角<18°）以及同侧髋关节手术或疾病史。使用受试者工作特征（ROC）分析确定 HOS-SSS 的 PASS、SCB 和 MOI 满意度。使用两种分布方法计算 HOS-SSS 的 MCID。
共有 225 名接受初次髋关节镜检查的运动员符合纳入标准。其中，200 名（88.9%）至少有 2 年的随访和关于重返运动（RTS）的信息，被纳入最终分析。该队列包括 124 名（62.0%）女性和 76 名（38.0%）男性，平均年龄 29.4±10.4 岁，平均体重指数为 25.6±5.4，平均随访时间为 29.5±5.1 个月。运动员在 HOS-SSS、mHHS、NAHS 和 VAS 方面从术前到最新的术后随访均有显著改善（<0.001），平均满意度为 8.2。RTS 率为 83.7%。ROC 分析确定，HOS-SSS 的 PASS、MOI 满意度阈值、SCB 绝对评分、SCB 变化评分和 MCID（基线/变化评分方法）分别为 77.0、44.6%、92.7、30.6 和 10.6，运动员达到这些阈值的比例很高（分别为 80.0%、80.5%、45.0%、54.0%和 79.5%）。
本研究确定了髋关节镜检查治疗 FAIS 后运动员的 HOS-SSS 可以用来定义有临床意义的结局的数值。在接受髋关节镜检查治疗 FAIS 的运动员中，HOS-SSS 的 PASS、MOI 满意度阈值、SCB 绝对评分、SCB 变化评分和 MCID（最低 2 年随访）分别为 77.0、44.6%、92.7、30.6 和 10.6。
