Zacharias Anthony J, Dooley Matthew, Mosiman Samuel, Spiker Andrea M
Department of Orthopedic Surgery Froedtert South, Pleasant Prairie, Wisconsin, U.S.A.
Department of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A.
Arthrosc Sports Med Rehabil. 2024 Mar 11;6(2):100871. doi: 10.1016/j.asmr.2023.100871. eCollection 2024 Apr.
To evaluate clinical depression scores and functional outcomes following arthroscopic treatment of femoroacetabular impingement syndrome in patients with elevated preoperative depressive symptoms as defined by Patient-Reported Outcomes Measurement Information System for Depression (PROMIS-D).
Patients with femoroacetabular impingement syndrome completed the PROMIS-D Computer Adaptive Test and additional patient-reported outcome (PRO) measures preoperatively and at the time of postoperative visits. Patients were categorized into preoperative clinically depressed (CD) and nonclinically depressed (NCD) groups based on preoperative PROMIS-D scores. Scores ≥55 correlate to mild clinical depression, and this cutoff was used to determine preoperative depression status. PROMIS-D scores and functional outcome scores were assessed at 6 months and a minimum of 1-year postoperatively.
In total, 100 patients were included with complete PROs at a minimum of 1-year follow-up. Of those included, 21 (21%) were categorized with preoperative CD. There were no differences in demographic or radiographic variables between the preoperative CD and NCD groups. At 6 months and 12 months postoperatively, the percentage of patients in the preoperative CD group with continued depression was 33.3% and 23.8%, respectively. Overall, 1-year change in PROMIS-D score for the CD group was -9.1 versus -0.8 in the NCD group ( = .001). There was no significant difference in rates of patients achieving patient acceptable symptom state between the preoperative CD and NCD groups.
Patients with symptoms of preoperative CD, as defined by the PROMIS-D score, demonstrated significant improvement in depressive symptoms following hip arthroscopy. In addition, patients with CD preoperatively did not show decreased rates of achieving minimum clinically important difference or patient acceptable symptom state on postoperative PROs compared with patients with NCD.
Level IV, therapeutic case series.
根据患者报告的抑郁症状测量信息系统(PROMIS-D)所定义的术前抑郁症状升高情况,评估关节镜治疗股骨髋臼撞击综合征后的临床抑郁评分和功能结果。
股骨髋臼撞击综合征患者在术前及术后随访时完成PROMIS-D计算机自适应测试及其他患者报告结局(PRO)测量。根据术前PROMIS-D评分,将患者分为术前临床抑郁(CD)组和非临床抑郁(NCD)组。评分≥55与轻度临床抑郁相关,以此临界值确定术前抑郁状态。在术后6个月和至少1年时评估PROMIS-D评分和功能结局评分。
总共纳入100例患者,至少进行了1年的完整PRO随访。其中,21例(21%)被分类为术前CD组。术前CD组和NCD组在人口统计学或影像学变量方面无差异。术后6个月和12个月时,术前CD组仍有抑郁症状的患者百分比分别为33.3%和23.8%。总体而言,CD组1年的PROMIS-D评分变化为-9.1,而NCD组为-0.8(P = 0.001)。术前CD组和NCD组达到患者可接受症状状态的患者比例无显著差异。
根据PROMIS-D评分定义的术前有CD症状的患者,在髋关节镜检查后抑郁症状有显著改善。此外,与NCD患者相比,术前有CD的患者在术后PROs上达到最小临床重要差异或患者可接受症状状态的比例并未降低。
IV级,治疗性病例系列。