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AOSSM 2023 Annual Meeting Recordings no CME
Patient Reported Outcomes Associated With “Complet ...
Patient Reported Outcomes Associated With “Completely Better” Status After Hip Arthroscopy
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Video Transcription
I'm Sean Meredith from the University of Maryland right up the road. This is patient-reported outcomes associated with completely better status two years after hip arthroscopy. Our disclosures are available on the website. We all know that hip arthroscopy has grown very rapidly. Because of that, it's especially important for us to understand patient-reported outcomes and to differentiate meaningful outcomes. So things such as PASS and MCID have been looked at in recent years in hip arthroscopy. However, the idea of a patient's perception of being completely better after hip arthroscopy is not something that has been looked at and may be of interest. So the purpose of this was to determine the prevalence and characteristics of patients who report being completely better two years after hip arthroscopy. We also wanted to determine whether PROs, measuring function, pain, and activity level are associated with this completely better status. And then determine predictive threshold values for achieving completely better status. So this is a study of 62 patients from our Maryland Orthopedic Registry. Multiple patient-reported outcome measures are included, including the PROMIS scores. And the completely better status question is a yes-no question that states for the patient, is the condition for which you underwent surgery completely better now? And then we performed typical analyses and then used receiver-operator characteristic curves to look at thresholds and area under curve. So of these 62 patients, 29 responded yes to the completely better, so just under half, 47%. This is our cohort. So it's mean age of 39, BMI of 27 and 79% female. The only difference in demographics between the completely better and non-completely better is single marital status was slightly higher in completely better. This is the patient-reported outcomes. And the patients that reported yes to completely better had significantly better on the left-hand side of the chart you can see, PROMIS physical function, pain interference, fatigue, social satisfaction and anxiety were all significantly better. And then on the right, numeric pain scores for the operative hip as well as the 2-year marks, activity rating scale, Tegner and then expectations and surgical satisfaction were better in the completely better. To determine thresholds, we looked for 90% specificity. And the predictive measures with the thresholds listed here that are significant is PROMIS physical function, pain interference, numeric pain scores in the operative hip, and then the met expectations and surgical satisfaction at 2 years. When we did a logistic regression model for this, the two independent predictors of being completely better were 2-year change in the PROMIS physical function and then the SSQ-8 which is surgical satisfaction at 2 years post-op. So 47% report being completely better 2 years after hip arthroscopy. We now have multiple thresholds that are associated with completely better status and can predict when patients will report this. And this includes physical function, pain interference and numeric pain scores. And the independent predictors are improvement in physical function, which for us is defined by the PROMIS physical function and 2-year post-operative surgical satisfaction. So there are limitations to this. So completely better status is something we're still trying to understand and it's a global subjective measure. So we don't know exactly what factors matter the most to the patients for them to report this. And it is a novel assessment. There's not a lot of comparison, but there is some with MCID and Substantial Clinical Benefit and PESS. This is a retrospective review of our database of course, and there is some loss to follow-up. We did not specifically compare this to IHOP, Harris Hip Scores and others. But this is the first study to report and assess a completely better status. We know that multiple 2-year and change in PROs are associated with this, but there's nothing pre-operative predictive. And change in physical function and satisfaction seem to be the most important factors. Thanks.
Video Summary
In this video, Sean Meredith from the University of Maryland discusses a study on patient-reported outcomes after hip arthroscopy. The aim of the study was to determine the prevalence and characteristics of patients who reported being completely better two years after the procedure. The study included 62 patients from the Maryland Orthopedic Registry, and various patient-reported outcome measures were used. The results showed that 47% of patients reported being completely better. Factors such as physical function, pain interference, and surgical satisfaction at two years were associated with completely better status. The study identified thresholds for predicting this status, with improvement in physical function and surgical satisfaction being the most important predictors. The limitations of the study include its retrospective nature and lack of pre-operative predictive factors.
Asset Caption
Sean Meredith, MD
Keywords
patient-reported outcomes
hip arthroscopy
prevalence
physical function
surgical satisfaction
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