Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China.
Beijing Key Laboratory of Sports Injuries, Beijing, China.
Orthop Surg. 2023 Jul;15(7):1756-1762. doi: 10.1111/os.13768. Epub 2023 May 26.
When considering surgical treatment options, many patients who undergo hip arthroscopy value continuing active lifestyles. To address these concerns, the purpose of this study was to determine the effect of preoperative activity level on postoperative patient-reported outcomes (PROs) in femoroacetabular impingement syndrome (FAIS) patients following hip arthroscopy.
Data was retrospectively reviewed for FAIS patients who received hip arthroscopy between 2016 and 2018. Patients were divided into active group and inactive group based on preoperative HOS-SSS scores. Preoperative active patients were 1:1 propensity-score matched to inactive patients based on age, sex, BMI, and follow-up period. PROs (HOS-ADL, HOS-ADL, iHOT-12, mHHS), VAS scores, radiographic measures, performed procedures, complications, and revision surgery were compared and analyzed for both groups by Student's t test.
A total of 71 patients in the active group and 71 patients in the inactive group were found using propensity-score matching. Active patients had superior preoperative HOS-ADL, HOS-SSS, iHOT-12, mHHS (p < 0.001 for all), and VAS (p = 0.002) scores compared with inactive patients. At the final follow-up, active patients still had better PROs in HOS-ADL (p = 0.003), HOS-SSS (p < 0.001), iHOT-12 (p = 0.043), and mHHS scores (p = 0.003). There was no difference detected in postoperative VAS score (p = 0.117) between the two groups. However, inactive patients showed significantly higher net improvement in HOS-ADL (p = 0.009), HOS-SSS (p = 0.005), and iHOT-12 (p = 0.023).
Active patients have absolute higher preoperative PROs and achieve better postoperative PROs than inactive patients. However, inactive patients can obtain greater net improvements in PROs following hip arthroscopic surgery, with comparable pain alleviation as active patients.
在考虑手术治疗方案时，许多接受髋关节镜检查的患者重视继续积极的生活方式。为了解决这些问题，本研究旨在确定髋关节镜检查治疗髋关节撞击综合征（FAIS）患者的术前活动水平对术后患者报告的结果（PROs）的影响。
回顾性分析了 2016 年至 2018 年期间接受髋关节镜检查的 FAIS 患者的数据。根据术前 HOS-SSS 评分将患者分为活跃组和不活跃组。根据年龄、性别、BMI 和随访时间，对术前活跃的患者进行 1:1 倾向评分匹配，与不活跃的患者进行匹配。比较并分析两组患者的 PROs（HOS-ADL、HOS-SSS、iHOT-12、mHHS）、VAS 评分、影像学测量、手术方式、并发症和翻修手术。
通过倾向评分匹配共找到 71 例活跃组和 71 例不活跃组患者。与不活跃组相比，活跃组患者术前 HOS-ADL、HOS-SSS、iHOT-12 和 mHHS 评分更高（所有 P 值均<0.001），VAS 评分更高（P=0.002）。在最终随访时，活跃组患者在 HOS-ADL（P=0.003）、HOS-SSS（P<0.001）、iHOT-12（P=0.043）和 mHHS 评分（P=0.003）方面仍具有更好的 PROs。两组患者术后 VAS 评分无差异（P=0.117）。然而，不活跃组患者在 HOS-ADL（P=0.009）、HOS-SSS（P=0.005）和 iHOT-12（P=0.023）方面的净改善明显更高。
活跃组患者术前 PROs 绝对较高，术后 PROs 优于不活跃组。然而，不活跃组患者在髋关节镜手术后可以获得更大的 PRO 净改善，与活跃组患者相比，疼痛缓解程度相当。
