White Alexander E, Varady Nathan H, Itthipanichpong Thun, Menta Samarth V, Ranawat Anil S
Sports Medicine Institute, Hospital for Special Surgery, 535 E 70th Street, New York, NY 10021, United States.
J Hip Preserv Surg. 2025 Jan 29;12(2):87-92. doi: 10.1093/jhps/hnae045. eCollection 2025 Jul.
Understanding the minimal clinically important difference (MCID) for a given procedure and its associated patient-reported outcome measures (PROMs) are critical for evaluating success in orthopedic surgery. The MCIDs for the International Hip Outcome Tool (iHOT-33) and Modified Harris Hip Score (mHHS) have been defined for open proximal hamstring repair (OPHR); however, the speed and reliability at which patients achieve these are unknown. A retrospective review of prospectively collected data from our institution's hip preservation registry was performed, examining pre-operative and 6-, 12-, and 24 months post-operative mHHS and iHOT-33 scores. The percentage of patients achieving MCID at each time point was determined, and factors associated with achieving MCID were assessed. A total of 37 patients were included in this analysis ( = 36 for iHOT-33 and = 32 for mHHS). At 6 months, 83% and 78% of patients achieved MCID for iHOT-33 and mHHS, respectively. Patients with chronic symptoms (pain >6 months) were significantly less likely to achieve at least one of the MCIDs at 6 months (60% vs. 12.5%, = .04), while patients with more severe preoperative pain were significantly more likely to achieve at least one of the MCIDs at 6 months ( = .004). Most patients who achieve the MCID for iHOT-33 and mHHS following OPHR do so by 6 months postoperatively. Chronic symptoms were associated with failure to achieve either one of the MCIDs at 6 months post-operatively. Patients with more severe preoperative pain were more likely to successfully achieve one of the MCIDs at 6 months.
了解特定手术的最小临床重要差异（MCID）及其相关的患者报告结局指标（PROMs）对于评估骨科手术的成功与否至关重要。国际髋关节结局工具（iHOT-33）和改良Harris髋关节评分（mHHS）的MCIDs已针对开放性近端腘绳肌修复术（OPHR）进行了定义；然而，患者达到这些指标的速度和可靠性尚不清楚。我们对本机构髋关节保留登记处前瞻性收集的数据进行了回顾性分析，检查术前以及术后6个月、12个月和24个月的mHHS和iHOT-33评分。确定了每个时间点达到MCID的患者百分比，并评估了与达到MCID相关的因素。本分析共纳入37例患者（iHOT-33为36例，mHHS为32例）。在6个月时，分别有83%和78%的患者达到iHOT-33和mHHS的MCID。有慢性症状（疼痛>6个月）的患者在6个月时达到至少一项MCID的可能性显著降低（60%对12.5%，P = 0.04），而术前疼痛更严重的患者在6个月时达到至少一项MCID的可能性显著增加（P = 0.004）。大多数在OPHR后达到iHOT-33和mHHS的MCID的患者在术后6个月时即达到。慢性症状与术后6个月未能达到任何一项MCID相关。术前疼痛更严重的患者在6个月时更有可能成功达到一项MCID。
