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&NA;. "Harris Hip Score." Journal of Orthopaedic Trauma 20, Supplement (2006): S78—S79. http://dx.doi.org/10.1097/00005131-200609001-00012.
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Hwang, Deuk-Soo, Chan Kang, Jeong-Kil Lee, Jae-Young Park, Long Zheng, and Jung-Mo Hwang. "The utility of hip arthroscopy for patients with painful borderline hip dysplasia." Journal of Orthopaedic Surgery 28, no. 2 (2020): 230949902092316. http://dx.doi.org/10.1177/2309499020923162.
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Purpose: We measured the width of the acetabular labra in, and the clinical outcomes of, patients with borderline hip dysplasia (HD) who underwent arthroscopy. Methods: A total of 1436 patients who underwent hip arthroscopy to treat symptomatic, acetabular labral tears were enrolled. From this cohort, we extracted a borderline HD group (162 cases). Lateral labral widths were evaluated using preoperative magnetic resonance imaging scans. Clinical data including the modified Harris hip score (mHHS), non-arthritic hip score (NAHS), hip outcome score–activity of daily living (HOS-ADL) score, visual analog scale (VAS) pain score, and Tönnis grade were collected. In addition, patient satisfaction with arthroscopy outcomes was rated. All complications and reoperations were noted. Results: The mean follow-up time was 87.4 months. The lateral labral width was 7.64 mm in those with normal hips and 7.73 mm in borderline HD patients, respectively ( p = 0.870). The Tönnis grade progressed mildly from 0.46 to 0.76 ( p = 0.227). At the last follow-up, clinical outcome scores (mHHS, NAHS, and HOS-ADL scores) and the VAS score were improved ( p < 0.001). The mean patient satisfaction was scored at 8.2. The reoperation rate was higher in those who underwent labral debridement (25.6%) than labral repair (4.1%). Conclusions: The lateral labral width did not differ significantly between the borderline HD group and the nondysplastic control group. Arthroscopy relieved the symptoms of painful borderline HD and did not accelerate osteoarthritis. Therefore, if such patients do not respond to conservative treatment, hip arthroscopy can be considered for further treatment.
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Mahomed, Nizar N., David C. Arndt, Brian J. McGrory, and William H. Harris. "The Harris hip score." Journal of Arthroplasty 16, no. 5 (2001): 575–80. http://dx.doi.org/10.1054/arth.2001.23716.
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Buchanan, James M. "16 Year Review of Hydroxyapatite Ceramic Coated Hip Implants - A Clinical and Histological Evaluation." Key Engineering Materials 284-286 (April 2005): 1049–52. http://dx.doi.org/10.4028/www.scientific.net/kem.284-286.1049.
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Traditionally implants for hip arthroplasty are secured with bone cement. Problems have been encountered with cement fixation with loosening and osteolysis attributed to the reaction to particulate cement material and also polyethylene debris from wear. Cementing techniques have been improved and the Swedish Hip Register [1] demonstrates that the revision rates have been reduced with improved cementing techniques. However, uncemented hip arthroplasty is now having a revival. In particular, bioactive materials are being used and this paper presents the results of a consecutive series of hip arthroplasties carried out over a total period of just 16 years. All the patients are included, including primary and revision hip arthroplasty. Patients are assessed using the Harris Hip Score [2]. 13% of the hips scored less than 80 on the Harris Hip Score but only 9.4% scored poor pain scores. These represent the results of poor hip arthroplasty, of which an even smaller percentage are related to failed HA hip arthroplasty.
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Robinson, Patrick G., Julian F. Maempel, Iain R. Murray, Conor S. Rankin, David F. Hamilton, and Paul Gaston. "Responsiveness and ceiling effects of the English version of the 12-item International Hip Outcome Tool following hip arthroscopy at minimum one-year follow-up." Bone & Joint Journal 102-B, no. 8 (2020): 1010–15. http://dx.doi.org/10.1302/0301-620x.102b8.bjj-2020-0074.r1.
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Aims Responsiveness and ceiling effects are key properties of an outcome score. No such data have been reported for the original English version of the International Hip Outcome Tool 12 (iHOT-12) at a follow-up of more than four months. The aim of this study was to identify the responsiveness and ceiling effects of the English version iHOT-12 in a series of patients undergoing hip arthroscopy for intra-articular hip pathology at a minimum of one year postoperatively. Methods A total of 171 consecutive patients undergoing hip arthroscopy with a diagnosis of femoroacetabular impingement (FAI) under the care of a single surgeon between January 2013 and March 2017 were included. iHOT-12 and EuroQol 5D-5L (EQ-5D-5L) scores were available pre- and postoperatively. Effect size and ceiling effects for the iHOT-12 were calculated with subgroup analysis. Results A total of 122 patients (71.3%) completed postoperative PROMs scores with median follow-up of 24.3 months (interquartile range (IQR) 17.2 to 33.5). The median total cohort iHOT-12 score improved significantly from 31.0 (IQR 20 to 58) preoperatively to 72.5 (IQR 47 to 90) postoperatively (p < 0.001). The effect size (Cohen’s d) was 1.59. In all, 33 patients (27%) scored within ten points (10%) of the maximum score and 38 patients (31.1%) scored within the previously reported minimal clinically important difference (MCID) of the maximum score. Furthermore, nine (47%) male patients aged < 30 years scored within 10% of the maximum score and ten (53%) scored within the previously reported MCID of the maximum score. Conclusion There is a previously unreported ceiling effect of the iHOT-12 at a minimum one-year follow-up which is particularly marked in young, male patients following hip arthroscopy for FAI. This tool may not have the maximum measurement required to capture the true outcome following this procedure. Cite this article: Bone Joint J 2020;102-B(8):1010–1015.
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Klavas, Derek M., Neil Duplantier, Brayden Gerrie, et al. "Patient-reported outcome score utilisation in arthroscopic hip preservation: we are all doing it differently, if at all." Journal of ISAKOS: Joint Disorders & Orthopaedic Sports Medicine 5, no. 4 (2020): 213–17. http://dx.doi.org/10.1136/jisakos-2018-000223.
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ObjectivesTo determine which outcome scores physicians are using in hip preservation surgery, as well as when they are administered, who administers them and on what platform.MethodsA cross-sectional survey was conducted to examine which patient-reported outcome (PRO) scores are being used by hip preservation surgeons, including hip joint–specific, lower extremity limb–specific, disease-specific, general health, quality of life, pain, activity, spine and psychiatric wellness scores. Descriptive statistics were calculated. Heterogeneity was assessed using I2 statistics.ResultsFifty-six surgeons responded (mean 169 arthroscopic, 65 open hip preservation surgeries per year; mean 13 years experience). 13% of surgeons did not collect any patient outcome scores. A total of 25 different PROs were reported. Of 13 possible hip joint–specific outcome scores, the modified Harris Hip Score was most frequently collected (46%), followed by International Hip Outcome Tool−12 (41%) and Hip Outcome Score (38%). There was considerable heterogeneity in hip joint–specific PROs (I2 86%). The Short Form−12 was the most common general health score (30%). Tegner and UCLA Activity scores were collected by 11% of participants. Fifty-nine per cent collected outcomes preoperatively, 45% at 3 months, 54% at 6 months, 61% at 1 year and 32% annually. Paper collection was the most common collection platform (46%), and a dedicated research assistant was most frequently the source of data collection (34%).ConclusionThis international survey demonstrates that although most hip preservation surgeons collect hip outcome scores, there is a large amount of heterogeneity in outcome scores used and method of collection. As hip preservation evidence continues to evolve, these results should emphasise the need for an initiative to standardise outcome score collection.Level of evidenceLevel V.
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Trofa, David, Robert Westermann, Mia Hagen, James Rosneck, T. Lynch, and Julian Sonnenfeld. "Outcomes Measures in Hip Arthroscopy." Journal of Hip Surgery 02, no. 04 (2018): 167–75. http://dx.doi.org/10.1055/s-0038-1676286.
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AbstractAs techniques in hip arthroscopy are rapidly advancing, patient-reported outcome (PRO) measures are becoming an integral part of measuring treatment effectiveness. The movement toward developing valid and reproducible outcome measurement tools has shifted from the traditional physician-derived data to patient-centered scores. As a result, the current standard for measuring the effectiveness of any surgical treatment is to use an outcome that reflects the patient's perspective. This review highlights the quality of the questionnaire properties and their application to the patient undergoing hip arthroscopy. Although the Modified Harris Hip Score (mHHS) has historically been used as the traditional outcome measure for hip surgery, new PRO tools in the field have been developed. The Nonarthritic Hip Score (NAHS) was intended for the younger, active patient to assess hip pain and function without radiographic findings. The Copenhagen Hip and Groing Outcome Score (HAGOS) and Hip Disability and Osteoarthritis Outcome Score (HOOS) both incorporated hip related quality of life measures. The Hip Outcome Score (HOS) was developed to assess the treatment outcomes of hip arthroscopy in young-to-middle-aged individuals. Finally, the International Hip Outcome Tool-33 (iHOT-33) addresses the outcomes of treatment in young active patients with hip disorders, in conjuction with the multicenter arthroscopy of the hip outcomes research network. Among the available literature comparing PROs in this patient population, the iHOT-33, HOS, and HOOS remain reliable, valid, and consistent available PRO tools for hip arthroscopy surgery.
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Papaliodis, Dean N., Michael B. Banffy, Orr Limpisvasti, et al. "The Development and Validation of a Subjective Assessment Tool for the Hip in the Athletic Population." American Journal of Sports Medicine 45, no. 11 (2017): 2517–23. http://dx.doi.org/10.1177/0363546517708200.
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Background: No validated functional assessments are available that are designed specifically to evaluate the performance and function of the athletic hip. Subsections of some validated outcome assessments address recreation, but a full assessment dedicated to athletic hip function does not exist. Current hip scoring systems may not be sensitive to subtle changes in performance and function in an athletic, younger population. Hypothesis: The patient-athlete subjective scoring system developed in this study will be validated, reliable, and responsive in the evaluation of hip function in the athlete. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Based on the results of a pilot questionnaire administered to 18 athletic individuals, a final 10-item questionnaire was developed. Two hundred fifty competitive athletes from multiple sports completed the final questionnaire and 3 previously validated hip outcome assessments. Each athlete was self-assigned to 1 of 3 injury categories: (1) playing without hip/groin trouble; (2) playing, but with hip/groin trouble; and (3) not playing due to hip/groin trouble. The injury categories contained 196, 40, and 14 athletes, respectively. Correlations between the assessment scores and injury categories were measured. Responsiveness testing was performed in an additional group of 24 injured athletes, and their scores before and after intervention were compared. Results: The Kerlan-Jobe Orthopaedic Clinic (KJOC) Athletic Hip Score showed high correlation with the modified Harris Hip Score, the Nonarthritic Hip Score, and the International Hip Outcome Tool. The new score stratified athletes by injury category, demonstrated responsiveness and accuracy, and varied appropriately with improvements in injury category after treatment of injuries. Conclusion: The new KJOC Athletic Hip Score is valid, reliable, and responsive for evaluation of the hip in an athletic population. The results support its use for the functional assessment of the hip in future studies.
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Umarji, S. I. M., M. B. Lee, M. F. Gargan, N. M. A. Portinaro, and I. D. Learmonth. "Total hip arthroplasty in skeletal dysplasia." HIP International 13, no. 3 (2003): 177–83. http://dx.doi.org/10.1177/112070000301300309.
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This study presents the results of 38 hip prostheses in 24 people of short stature (under 152 cm). A retrospective clinical and radiological study recording the diagnosis, age at reconstruction, height, weight, type of prostheses, length of follow-up, radiological appearances and patient satisfaction was performed. Harris hip scores were used to assess activities of daily living (1). All patients were under 152cm and their diagnoses included achondroplasia, spondyloepiphyseal dysplasia, multiple epiphyseal dysplasia, developmental dysplasia of the hip and juvenile chronic arthritis. The mean height of these patients was 135 cm (range: 109cm to 150cm). The mean age was 38 years (range: 19 to 75 years) with mean follow-up 67 months (range: 12 to 406 months). Only one patient, who is now aged 69 years (though 65 years at revision surgery), has required revision surgery to date. The results were excellent for 33 hips (Harris hip score between 80–100), good in three (Harris hip score between 70–80), satisfactory in one (score 60–70) and poor for one (Harris hip score <50). The mean Harris hip score to date is 89. Hip replacement surgery is difficult in this challenging group of patients but can nonetheless yield gratifying results in over 90% of cases.
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Potter, Benjamin K., Brett A. Freedman, Romney C. Andersen, John A. Bojescul, Timothy R. Kuklo, and Kevin P. Murphy. "Correlation of Short Form-36 and Disability Status with Outcomes of Arthroscopic Acetabular Labral Debridement." American Journal of Sports Medicine 33, no. 6 (2005): 864–70. http://dx.doi.org/10.1177/0363546504270567.
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Background Arthroscopic debridement is the standard of care for the treatment of acetabular labral tears. The Short Form-36 has not been used to measure hip arthroscopy outcomes, and the impact of disability status on hip arthroscopy outcomes has not been reported. Hypothesis Short Form-36 subscale scores will demonstrate good correlation with the modified Harris hip score, but patients undergoing disability evaluation will have significantly worse outcome scores. Study Design Case series; Level of evidence, 4. Methods The records of active-duty soldiers who underwent hip arthroscopy at the authors’ institution were retrospectively reviewed. Forty consecutive patients who underwent hip arthroscopy for the primary indication of labral tear formed the basis of the study group. Patients completed the modified Harris hip score, the Short Form-36 general health survey, and a subjective overall satisfaction questionnaire. Results Thirty-three patients, with a mean age of 34.6 years, were available for follow-up at a mean of 25.7 months postoperatively. Fourteen (43%) patients were undergoing medical evaluation boards (military equivalent of workers’ compensation or disability claim). Pearson correlation coefficients for comparing the Short Form-36 Bodily Pain, Physical Function, and Physical Component subscale scores to the modified Harris hip score were 0.73, 0.71, and 0.85, respectively (P <. 001). The mean modified Harris hip score was significantly lower in patients on disability status than in those who were not (92.4 vs 61.1; P <. 0001). The Short Form-36 subscale scores were significantly lower in disability patients (P <. 02). Patient-reported satisfaction rates (70% overall) were 50% for those undergoing disability evaluations and 84% for those who were not (P <. 04). There was no significant difference in outcomes based on patient age, surgically proven chondromalacia, or gender for military evaluation board status. Conclusion The Short Form-36 demonstrated good correlation with the modified Harris hip score for measuring outcomes after arthroscopic partial limbectomy. Arthroscopic debridement yielded a high percentage of good results when patients undergoing disability evaluations were excluded. Disability status may be a negative predictor of success after hip arthroscopy.
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Michael, A., K. Eagland, and L. Doos. "ASA Score in hip fracture patients." European Geriatric Medicine 3 (September 2012): S50. http://dx.doi.org/10.1016/j.eurger.2012.07.059.
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Lau, Brian C., Melissa Scribani, Tally Lassiter, and Jocelyn Wittstein. "Correlation of Single Assessment Numerical Evaluation Score for Sport and Activities of Daily Living to Modified Harris Hip Score and Hip Outcome Score in Patients Undergoing Arthroscopic Hip Surgery." American Journal of Sports Medicine 47, no. 11 (2019): 2646–50. http://dx.doi.org/10.1177/0363546519863411.
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Background: The Single Assessment Numerical Evaluation (SANE) is a single-question outcome score that has been shown to be a reliable measure of outcomes for shoulder and knee injuries but has not been compared with other validated outcome scores in hip pathology managed arthroscopically. Purpose: To correlate SANE Activities of Daily Living (ADL) and Sport subscales with the modified Harris Hip Score (mHHS) and Hip Outcome Score (HOS) ADL and Sport subscales before and after arthroscopic hip surgery. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: A retrospective review of a prospectively filled database of patients undergoing arthroscopic hip surgery by a single surgeon was conducted. Inclusion criteria included patients scheduled for arthroscopic hip surgery for femoroacetabular impingement, labral tear, or gluteus medius tear. Exclusion criteria included previous surgery to the hip. Outcome scores, including the mHHS, HOS ADL and Sport, and SANE ADL and Sport, were measured preoperatively and postoperatively at 3 months, 1 year, and then annually. Pearson correlation coefficients between preoperative SANE ADL and Sport and the mHHS, HOS ADL, and HOS Sport were calculated. Pearson correlation coefficients between postoperative SANE ADL and Sport and the mHHS, HOS ADL, and HOS Sport were also calculated. Results: Eighty-five patients (mean age, 37.9 years; range, 14-66 years; 57 females, 28 males) underwent arthroscopic hip surgery for assorted pathology. Mean follow-up was 8 months (range, 3-64 months). Based on the Pearson correlation coefficient, preoperative SANE ADL and Sport had a moderate correlation with the mHHS ( r = 0.66; 95% CI, 0.47-0.79; P < .0001; r = 0.54; 95% CI, 0.31-0.71; P < .0001, respectively). Preoperative SANE ADL and Sport had a moderate correlation with HOS ADL ( r = 0.60; 95% CI, 0.39-0.75; P < .0001) and HOS Sport ( r = 0.65; 95% CI, 0.45-0.79; P < .0001). Postoperative SANE ADL and Sport had a strong correlation with the mHHS ( r = 0.69; 95% CI, 0.50-0.82; P < .0001; r = 0.78; 95% CI, 0.61-0.88; P < .0001). Postoperative SANE ADL and Sport had a strong correlation with HOS ADL ( r = 0.79; 95% CI, 0.65-0.88; P < .0001) and HOS Sport ( r = 0.88; 95% CI, 0.78-0.94; P < .0001). Conclusion: This study showed a significant correlation between SANE and mHHS in patients undergoing arthroscopic hip surgery both pre- and postoperatively. SANE ADL and Sport had a strong correlation with HOS ADL and Sport preoperatively and short-term postoperatively. SANE scores are more highly correlated with traditional subjective outcome measures during the short-term postoperative period than they are preoperatively. The SANE score provides an efficient method of assessing outcomes after hip arthroscopy.
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Lam, Ming-Tuen, Chor-Wing Sing, Gloria H. Y. Li, Annie W. C. Kung, Kathryn C. B. Tan, and Ching-Lung Cheung. "Development and Validation of a Risk Score to Predict the First Hip Fracture in the Oldest Old: A Retrospective Cohort Study." Journals of Gerontology: Series A 75, no. 5 (2019): 980–86. http://dx.doi.org/10.1093/gerona/glz178.
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Abstract Background To evaluate whether the common risk factors and risk scores (FRAX, QFracture, and Garvan) can predict hip fracture in the oldest old (defined as people aged 80 and older) and to develop an oldest-old-specific 10-year hip fracture prediction risk algorithm. Methods Subjects aged 80 years and older without history of hip fracture were studied. For the derivation cohort (N = 251, mean age = 83), participants were enrolled with a median follow-up time of 8.9 years. For the validation cohort (N = 599, mean age = 85), outpatients were enrolled with a median follow-up of 2.6 years. A five-factor risk score (the Hong Kong Osteoporosis Study [HKOS] score) for incident hip fracture was derived and validated, and its predictive accuracy was evaluated and compared with other risk scores. Results In the derivation cohort, the C-statistics were .65, .61, .65, .76, and .78 for FRAX with bone mineral density (BMD), FRAX without BMD, QFracture, Garvan, and the HKOS score, respectively. The category-less net reclassification index and integrated discrimination improvement of the HKOS score showed a better reclassification of hip fracture than FRAX and QFracture (all p &lt; .001) but not Garvan, while Garvan, but not HKOS score, showed a significant over-estimation in fracture risk (Hosmer–Lemeshow test p &lt; .001). In the validation cohort, the HKOS score had a C-statistic of .81 and a considerable agreement between expected and observed fracture risk in calibration. Conclusion The HKOS score can predict 10-year incident hip fracture among the oldest old in Hong Kong. The score may be useful in identifying the oldest old patients at risk of hip fracture in both community-dwelling and hospital settings.
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Sharma, Sanjeev, Ravi Shah, Kingsley Paul Draviraj, and M. S. Bhamra. "Use of telephone interviews to follow up patients after total hip replacement." Journal of Telemedicine and Telecare 11, no. 4 (2005): 211–14. http://dx.doi.org/10.1258/1357633054068883.
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We studied the feasibility of telephone interviews to assess hip function in patients who had had a total hip replacement. One hundred patients attending the orthopaedic clinic for follow-up after undergoing total hip replacement were studied. A modified Harris hip score was used. Since range of motion and deformity cannot be assessed by telephone, only pain and function were assessed. The maximum possible score was 100. Patients attending follow-up clinics were contacted by telephone one to two weeks prior to their appointment and a telephone assessment was completed. This was then compared with a face-to-face assessment in the subsequent clinic. The mean hip score obtained with the telephone interview was 85.2 and the mean hip score at face-to-face assessment was 86.1. The mean of the differences between the individual scores was −0.9 (SD 5.5). This difference was not significant ( P=0.11). Only three patients had a clinically significant difference (>20 points) between the two methods. Telephone questionnaires may be a useful adjunct to face-to-face assessment for patient follow-up after total hip replacement.
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Larsson, Amanda, Ola Rolfson, and Johan Kärrholm. "Evaluation of Forgotten Joint Score in total hip arthroplasty with Oxford Hip Score as reference standard." Acta Orthopaedica 90, no. 3 (2019): 253–57. http://dx.doi.org/10.1080/17453674.2019.1599252.
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Beck, Edward C., Benedict U. Nwachukwu, Laura M. Krivicich, et al. "Preoperative Hip Extension Strength Is an Independent Predictor of Achieving Clinically Significant Outcomes After Hip Arthroscopy for Femoroacetabular Impingement Syndrome." Sports Health: A Multidisciplinary Approach 12, no. 4 (2020): 361–72. http://dx.doi.org/10.1177/1941738120910134.
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Background: The effect of preoperative hip strength on outcomes after hip arthroscopy for femoroacetabular impingement syndrome (FAIS) is unclear. The purpose of this study was to determine whether preoperative isometric hip strength is associated with outcome scores at 6 months as well as achieving the minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS) in patients undergoing hip arthroscopy for FAIS. Hypothesis: Increased preoperative isometric strength will be correlated with short-term postoperative outcomes and will be predictive of achieving higher functional status. Study Design: Case series. Level of Evidence: Level 4. Methods: Data from 92 consecutive patients undergoing primary hip arthroscopy for treatment of FAIS from March through August 2018 were analyzed. All patients included in the analysis had preoperative measures of isometric hip strength on both affected and unaffected limbs, as well as preoperative and 6-month patient-reported outcome (PRO) scores. Analysis was performed to determine correlations between normalized isometric hip strength measurements and PROs and whether strength measurements were predictive of achieving MCID or PASS. Results: A total of 74 (80.4%) patients had 6-month PROs and were included in the final analysis. Hip extension strength on both sides was correlated with all postoperative PROs (all P > 0.05). Abduction strength on both sides was correlated with postoperative Hip Outcome Score–Activities of Daily Living subscale score, achieving MCID on at least 1 score threshold, and reaching the international Hip Outcome Tool-12 threshold score for achieving PASS (all P < 0.05). Regression analysis showed that extension strength on the affected side was the only strength measurement predictor of achieving PASS (1.043; P = 0.049). Conclusion: Preoperative isometric hip extension and abduction strength are correlated with 6-month postoperative PRO scores. Furthermore, hip extension strength is a predictor of achieving clinically meaningful outcomes. Clinical Relevance: This study highlights the possible importance of preoperative optimization of hip function to maximize outcomes in patients undergoing hip arthroscopy for FAIS.
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Marahatta, Suman Babu, Dirgha Raj RC, Kapil Mani KC, and Arun Sigdel. "Functional Outcome Of primary Total Hip Arthroplasty using Harris Hip Score in Arthritic Hip." Europasian Journal of Medical Sciences 2, no. 2 (2020): 4–10. http://dx.doi.org/10.46405/ejms.v2i2.78.
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Introduction: Total hip arthroplasty (THA) is a well-established procedure for advanced arthritis of the hip joint. It significantly improves the quality of life by relieving pain and improving functional disability. The objective of this study was to evaluate the clinical and functional outcome of primary total hip arthroplasty using the Harris Hip Score.
 Method: Prospective study was conducted in Civil Service Hospital. Out of 145 THA performed from Jan 2014 to Dec 2018, the first 100 cases that fulfilled the inclusion criteria were analyzed. Patient demographic and site, operative indication, and pre-operative Harris Hip Score was documented. Operative time, total intraoperative blood loss, and complications were noted. Patients were followed in 3 weeks, 6 weeks, 3 months, 6 months, and yearly. In each visit, clinical evaluation using Harris Hip Score and radiological evaluation was done and documented. The duration of follow up ranged from 12 months to 4.5 years.
 Results: Age varied from 21 to 75 years, 59% were male and 41% female, right side involvement was seen in 55% and left side in 45%. The major indication for surgery was avascular necrosis 46% and primary osteoarthritis in 24%. The average operative time was 65 minutes and the average intraoperative blood loss was 655 ml. Pre-operative Harris Hip Score ranged from 25 to 59 with a mean of 45.5. The mean Harris hip score in last follow up increased to 90.5 with a minimum of 76 and a maximum of 97. Our study found that 85% had excellent, 9% had good and 6% had fair results. Complications include 2% dislocation, 1% infection, 1% greater trochanter avulsion and 1% screw irritation.
 Conclusion: Primary THA is a safe and effective procedure. It improves pain and function hence improving the activity of daily living and has fewer complications.
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Nguyen, Thu Quynh, James M. Friedman, Sergio E. Flores, and Alan L. Zhang. "Fast Starters and Slow Starters After Hip Arthroscopy for Femoroacetabular Impingement: Correlation of Early Postoperative Pain and 2-Year Outcomes." American Journal of Sports Medicine 48, no. 12 (2020): 2903–9. http://dx.doi.org/10.1177/0363546520952406.
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Background: Patients experience varying degrees of pain and symptoms during the early recovery period after hip arthroscopy for femoroacetabular impingement (FAI). Some “fast starters” report minimal discomfort and are eager to advance activities, while “slow starters” describe severe pain and limitations. The relationship between these early postoperative symptoms and 2-year outcomes after hip arthroscopy is unknown. Purpose: To analyze the relationship between early postoperative pain and 2-year patient-reported outcomes (PROs) after hip arthroscopy for FAI. Study Design: Cohort study; Level of evidence, 2. Methods: Patients without arthritis or dysplasia who were undergoing primary hip arthroscopy for FAI were prospectively enrolled and completed validated PROs. Scores for visual analog scale (VAS) for pain were collected preoperatively and at 1 week, 6 weeks, and 2 years postoperatively. Scores for the modified Harris Hip Score (mHHS), Hip disability and Osteoarthritis Outcome Score (HOOS), and 12-Item Short Form Health Survey (SF-12) were collected preoperatively and 2 years postoperatively. Paired t tests were used to evaluate PRO score changes, and correlation analyses were used to assess relationships between early postoperative pain and 2-year postoperative outcomes. Results: A total of 166 patients were included (55% female; mean ± SD age, 35.29 ± 9.6 years; mean body mass index, 25.07 ± 3.98 kg/m2). Patients demonstrated significant improvements in PRO scores (VAS, SF-12 Physical Component Score, mHHS, and all HOOS subscales) at 2 years after hip arthroscopy for FAI ( P < .001). There was a significant correlation between lower 1-week VAS pain level (fast starters) and lower 2-year VAS pain level ( R = 0.31; P < .001) as well as higher 2-year PRO scores (SF-12 Physical Component Score, mHHS, and all HOOS subscales: R = −0.21 to −0.3; P < .001). There was no correlation between 1-week VAS pain and 2-year SF-12 Mental Component Score ( P = .17). Preoperative VAS pain levels showed positive correlations with 1-week postoperative pain scores ( R = 0.39; P < .001) and negative correlations with 2-year patient outcomes ( R = −0.15 to −0.33, P < .01). There was no correlation between 6-week postoperative pain scores and 2-year PRO scores. Conclusion: Fast starters after hip arthroscopy for FAI experience sustained improvements in outcomes at 2 years after surgery. Patient pain levels before surgery may delineate potential fast starters and slow starters.
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BERTAMINO, MARTA, FEDERICA ROSSI, ANGELA PISTORIO, et al. "Development and Initial Validation of a Radiographic Scoring System for the Hip in Juvenile Idiopathic Arthritis." Journal of Rheumatology 37, no. 2 (2009): 432–39. http://dx.doi.org/10.3899/jrheum.090691.
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Objective. To develop and validate a radiographic scoring system for the assessment of radiographic damage in the hip joint in patients with juvenile idiopathic arthritis (JIA).Methods. The Childhood Arthritis Radiographic Score of the Hip (CARSH) assesses and scores these radiographic abnormalities: joint space narrowing (JSN), erosion, growth abnormalities, subchondral cysts, malalignment, sclerosis of the acetabulum, and avascular necrosis of the femoral head. Score validation was accomplished by evaluating reliability and correlational, construct, and predictive validity in 148 JIA patients with hip disease who had a total of 381 hip radiographs available for study.Results. JSN was the most frequently observed radiographic abnormality, followed by erosion and sclerosis of the acetabulum. The least common abnormalities were avascular necrosis, growth abnormalities, and malalignment. Interobserver and intraobserver reliability on baseline and longitudinal score values and on score changes was good, with intraclass correlation coefficients ranging from 0.76 to 0.98. Early score changes, but not absolute baseline score values, were moderately correlated (rs > 0.4) with clinical indicators of disease damage at last followup observation, thereby demonstrating that the CARSH has good construct and predictive validity. The amount of structural damage in the hip radiograph at last followup observation was predicted better by baseline to 1-year score change (rs = 0.66; p < 0.0001) than by absolute baseline score values (rs = 0.40; p = 0.002).Conclusion. Our results show that the CARSH is reliable and valid for the assessment of radiographic hip damage and its progression in patients with JIA.
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Péchon, Pierre H. M., Katherine Butler, George Murphy, and Gian C. Singer. "The perils of PROMs: question 5 of the Oxford Hip Score is ambiguous to 10% of English-speaking patients: a survey of 135 patients." HIP International 29, no. 3 (2018): 299–302. http://dx.doi.org/10.1177/1120700018775317.
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Introduction: The Oxford Hip Score (OHS) is a commonly used patient-reported outcome measure (PROM), comprising 12 questions. We present the incidental finding that one of the 12 questions is ambiguous. Materials and methods: As part of a 10-year follow-up of patients treated with hip resurfacing the OHS was posted to 148 patients; 135 (91%) replied. Scores were read by 2 orthopaedic surgery trainees and entered into a database. It was noted that Question 5 was frequently mis-interpreted. Results: Thirteen patients’ questionnaires (10%) showed the same inconsistency: question 5 was scored as 0 points but the other 11 questions were scored as either 3 or 4 in 97% of cases. The ethnic group of all 13 patients was recorded in hospital data as being White-British. Conclusion: Question 5 of the OHS is ambiguous to 10% of native English-speakers. These patients rated their hip function highly, as reflected by the fact that 97% of the questions other than question 5 scored 3 or 4, indeed 87% of them scored 4. We hypothesise that the wording of the zero score option “Not at all” is being mis-interpreted as a response indicating that the patient does not suffer any pain at all. The effect is an error of 4 points out of 48 (8%); this may under-estimate the patient’s hip score. Surgeons are under great scrutiny to prove efficacy of surgical interventions; this is often provided by PROMs. We should strive to formulate the most accurate, reproducible and least ambiguous PROMs questionnaires.
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Hevesi, Mario, Aaron J. Krych, Nick R. Johnson, et al. "Multicenter Analysis of Midterm Clinical Outcomes of Arthroscopic Labral Repair in the Hip: Minimum 5-Year Follow-up." American Journal of Sports Medicine 46, no. 2 (2017): 280–87. http://dx.doi.org/10.1177/0363546517734180.
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Background: The technique of hip arthroscopic surgery is advancing and becoming more commonly performed. However, most current reported results are limited to short-term follow-up, and therefore, the durability of the procedure is largely unknown. Purpose: To perform a multicenter analysis of mid-term clinical outcomes of arthroscopic hip labral repair and determine the risk factors for patient outcomes. Study Design: Cohort study; Level of evidence, 3. Methods: Prospectively collected data of primary hip arthroscopic labral repair performed at 4 high-volume centers between 2008 and 2011 were reviewed retrospectively. Patients were assessed preoperatively and postoperatively with the visual analog scale (VAS), modified Harris Hip Score (mHHS), and Hip Outcome Score–Sports-Specific Subscale (HOS-SSS) at a minimum of 5 years’ follow-up. Factors including age, body mass index (BMI), Tönnis grade, and cartilage grade were analyzed in relation to outcome scores, and revision rates were determined. Failure was defined as subsequent ipsilateral hip surgery, including revision arthroscopic surgery and open hip surgery. Results: A total of 303 patients (101 male, 202 female) with a mean age of 32.0 years (range, 10.7-58.9 years) were followed for a mean of 5.7 years (range, 5.0-7.9 years). Patients achieved mean improvements in VAS of 3.5 points, mHHS of 20.1 points, and HOS-SSS of 29.3 points. Thirty-seven patients (12.2%) underwent revision arthroscopic surgery, and 12 (4.0%) underwent periacetabular osteotomy, resurfacing, or total hip arthroplasty during the study period. Patients with a BMI >30 kg/m2 had a mean mHHS score 9.5 points lower and a mean HOS-SSS score 15.9 points lower than those with a BMI ≤30 kg/m2 ( P < .01). Patients aged >35 years at surgery had a mean mHHS score 4.5 points lower and a HOS-SSS score 6.7 points lower than those aged ≤35 years ( P = .03). Patients with Tönnis grade 2 radiographs demonstrated a 12.5-point worse mHHS score ( P = .02) and a 23.0-point worse HOS-SSS score ( P < .01) when compared with patients with Tönnis grade 0. Conclusion: Patients demonstrated significant improvements in VAS, mHHS, and HOS-SSS scores after arthroscopic labral repair. However, those with Tönnis grade 2 changes preoperatively, BMI >30 kg/m2, and age >35 years at the time of surgery demonstrated significantly decreased mHHS and HOS-SSS scores at final follow-up.
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Aulakh, TS, EV Robinson, and JB Richardson. "PAR33 OSWESTRY HIP SCORE: A PATIENT ASSESSED TOOLTO MEASURE HIP FUNCTION." Value in Health 10, no. 6 (2007): A253. http://dx.doi.org/10.1016/s1098-3015(10)64948-0.
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Martin, RobRoy L., and Marc J. Philippon. "Evidence of Validity for the Hip Outcome Score in Hip Arthroscopy." Arthroscopy: The Journal of Arthroscopic & Related Surgery 23, no. 8 (2007): 822–26. http://dx.doi.org/10.1016/j.arthro.2007.02.004.
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Minkara, Anas, Michaela O’Connor, Robert W. Westermann, James T. Rosneck, and Thomas Sean Lynch. "Patient-Reported Outcomes Measurement Information System (PROMIS) in Femoroacetabular Impingement (FAI)." Orthopaedic Journal of Sports Medicine 7, no. 7_suppl5 (2019): 2325967119S0026. http://dx.doi.org/10.1177/2325967119s00266.
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Objectives: Patient-Reported Outcomes Measurement Information System (PROMIS) is an NIH-funded computerized adaptive test (CAT) developed to effectively assess patient outcomes in multiple domains, including physical function (PF), pain severity, and quality of life while minimizing patient burden. The purpose of this study is to validate PROMIS in patients undergoing hip arthroscopy for Femoroacetabular Impingement (FAI), including test-retest reliability and correlation with validated hip outcome measures. Methods: Patients undergoing elective hip arthroscopy for FAI were consecutively enrolled at a major academic center. Patients with chronic comorbidities, bilateral FAI with a staged approach, and lack of postoperative follow-up were excluded. Eligible patients completed the modified Hip Harris Score (mHHS), Hip Outcome Score Activities of Daily Living (HOS-ADL), International Hip Outcome Tool (iHOT-12), and PROMIS including PF, pain interference, and activity satisfaction. Questionnaires were completed preoperatively, two, and six weeks postoperatively. Ceiling effects were determined to be present if greater than 15% of patients scored the highest possible score on one of the patient reported outcome measurement tools in this study. The correlation of preoperative values with postoperative function were assessed utilizing the Pearson coefficient. Normality was evaluated using the Shapiro-Wilk test. Dependent sample t-tests were utilized to compare means in test-retest reliability. Results: There were 38 patients with a mean age of 29.3 ± 8.9 years (54% female) identified for the study. PROMIS demonstrated excellent correlation with HOS-ADL (Pearson coefficient of 0.81, Figure 1), as well as mHHS (0.80) and iHOT-12 (0.73). Patients with higher PROMIS-pain interference and pain intensity scores demonstrated a negative linear correlation with mHHS (r=-0.86, p<0.05), HOS-ADL (r=-0.71, p<0.05), and iHOT-12 (-0.71, p<0.01). PROMIS scores exhibited significant responsiveness to hip arthroscopy. Patients with higher activity satisfaction demonstrated excellent-good correlation with mHHS scores (r=0.66, p<0.05) and HOS-ADL (0.66, p<0.05). PROMIS also demonstrated excellent test-retest reliability with no variability in scores, including PF (55.5 ± 8.6 vs. 54.2 ± 10.5, p=0.74). No floor or ceiling effects were exhibited by PROMIS including the physical function, pain interference, pain intensity, social participation, and role satisfaction domain scores. Conclusion: PROMIS is a valid and efficient PRO in hip arthroscopy for FAI demonstrating excellent test-retest reliability and correlation with established hip outcome measures. No floor or ceiling effects were demonstrated by PROMIS. Subdomains also exhibit excellent prognostic ability in the clinical setting.
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Stone, Austin V., Philip Malloy, Edward C. Beck, et al. "Predictors of Persistent Postoperative Pain at Minimum 2 Years After Arthroscopic Treatment of Femoroacetabular Impingement." American Journal of Sports Medicine 47, no. 3 (2019): 552–59. http://dx.doi.org/10.1177/0363546518817538.
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Background: Hip arthroscopy for femoroacetabular impingement syndrome (FAIS) is a rapidly expanding field, and preoperative factors predictive of persistent postoperative pain are currently unknown. Purpose: To identify predictors for persistent postoperative pain at the site of surgery after hip arthroscopy for FAIS. Study Design: Case-control study; Level of evidence, 3. Methods: Patients who underwent hip arthroscopy for FAIS and had a minimum 2-year follow-up with patient-reported outcomes (PROs) were included in this study. Patients with previous open hip surgery and diagnoses other than FAIS were excluded. Patients were grouped by visual analog scale scores for pain as limited (<30) and persistent (≥30). Patient factors and outcomes were analyzed with univariate and correlation analyses to build a logistic regression model to identify predictors of persistent postoperative pain. Results: The limited pain (n = 514) and persistent pain (n = 174) groups totaled 688 patients (449 females). There was a statistically significant difference in age between groups, with the persistent pain group being older than the low pain group (35.9 ± 12.2 vs 32.4 ± 12.6, respectively; P = .002). Patients with persistent postoperative pain demonstrated significantly lower preoperative PRO scores in the Hip Outcome Score–Activities of Daily Living (57.6 ± 21.2 vs 67.7 ± 16.8), Hip Outcome Score–Sport Specific (35.9 ± 23.9 vs 44.1 ± 22.7), modified Harris Hip Score (51.6 ± 16.2 vs 59.6 ± 12.9), and International Hip Outcome Tool (32.0 ± 16.8 vs 40.0 ± 17.82) but no significant differences in preoperative visual analog scale scores for pain (7.3 ± 1.8 vs 7.2 ± 1.7). Mean postoperative PRO differences between pain groups were all statistically significant. Bivariate logistic regression analysis demonstrated that history of anxiety or depression (odds ratio, 1.8; 95% CI, 1.02-3.32; P = .042), revision hip arthroscopy (odds ratio, 8.6; 95% CI, 1.79-40.88; P = .007), and a low preoperative modified Harris Hip Score (odds ratio, 0.97; 95% CI, 0.95-0.99; P = .30) were predictors of persistent postoperative pain. Conclusion: Independent predictors for persistent postoperative pain include revision hip arthroscopy and mental health history positive for anxiety and depression. Our analysis demonstrated significant improvements in pain and functional PROs in the limited pain and persistent pain groups; however, those with persistent pain demonstrated significantly lower PRO scores.
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Kalairajah, Yegappan, Koldo Azurza, Christopher Hulme, Sean Molloy, and Khalid J. Drabu. "Health Outcome Measures in the Evaluation of Total Hip Arthroplasties—A Comparison Between the Harris Hip Score and the Oxford Hip Score." Journal of Arthroplasty 20, no. 8 (2005): 1037–41. http://dx.doi.org/10.1016/j.arth.2005.04.017.
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Gilbey, Helen J., Timothy R. Ackland, Jeff Tapper, and Allan W. Wang. "PERIOPERATIVE EXERCISE IMPROVES FUNCTION FOLLOWING TOTAL HIP ARTHROPLASTY: A RANDOMIZED CONTROLLED TRIAL." Journal of Musculoskeletal Research 07, no. 02 (2003): 111–23. http://dx.doi.org/10.1142/s0218957703001046.
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Until recently, limited evidence existed to support the efficacy of exercise programs for patients scheduled for total hip arthroplasty (THA), and no evidence-based guidelines were available regarding the length or intensity of exercise programs and their effect on patient recovery. The purpose of this randomized controlled trial was to determine the impact of an eight-week pre-surgery and 20 week post-surgery customized exercise program on the strength and function of subjects scheduled for THA. A series of physical tests and quality of life questionnaires were completed by patients (n = 57) pre-surgery and on three occasions post-surgery. In the week prior to surgery, the exercise group exhibited significant improvements (p < 0.05) in composite hip strength score and WOMAC total score in comparison to control subjects. By week 24, post-surgery scores for WOMAC total score, Harris Hip score, composite strength score, hip flexion range of motion of the operated hip and the distance walked in 6 minutes were significantly (p < 0.05) better in exercise group patients. A detailed description of the exercise intervention is presented in this paper.
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Shaikh, Abdul Malik, Muhammad Bakhsh Shahwani, and Mohammad Ishaq. "HIP FRACTURE." Professional Medical Journal 25, no. 01 (2018): 30–33. http://dx.doi.org/10.29309/tpmj/18.4179.
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Perets, Itay, Danil Rybalko, Brian H. Mu, et al. "In Revision Hip Arthroscopy, Labral Reconstruction Can Address a Deficient Labrum, but Labral Repair Retains Its Role for the Reparable Labrum: A Matched Control Study." American Journal of Sports Medicine 46, no. 14 (2018): 3437–45. http://dx.doi.org/10.1177/0363546518809063.
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Background: Revision hip arthroscopy is increasingly common and often addresses acetabular labrum pathology. There is a lack of consensus on indications or outcomes of revision labral repair versus reconstruction. Purpose: To report clinical outcomes of labral reconstruction during revision hip arthroscopy at minimum 2-year follow-up as compared with pair-matched labral repair during revision hip arthroscopy (control group) and to suggest a decision-making algorithm for labral treatment in revision hip arthroscopy. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who underwent revision hip arthroscopy with labral reconstruction were matched 1:2 with patients who underwent revision arthroscopic labral repair. Patients were matched according to age, sex, and body mass index. Outcome scores, including the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score, Hip Outcome Score–Sport-Specific Subscale, and a visual analog scale for pain, were collected preoperatively and at minimum 2-year follow-up. At latest follow-up, patient satisfaction on a 0-10 scale and the abbreviated International Hip Outcome Tool (iHOT-12) were collected. Complications, subsequent arthroscopies, and conversion to total hip arthroplasty were collected as well. Results: A total of 15 revision labral reconstructions were pair matched to 30 revision labral repairs. The reconstructions had fewer isolated Seldes type I detachments ( P = .008) and lower postoperative lateral center-edge angle, but there were otherwise no significant differences in demographics, radiographics, intraoperative findings, or procedures. Both groups demonstrated significant improvements in all outcomes and visual analog scale at minimum 2-year follow-up. The revision repairs trended toward better preoperative scores: mHHS (mean ± SD: 59.3 ± 16.5 vs 54.2 ± 16.0), Non-Arthritic Hip Score (61.0 ± 16.7 vs 51.2 ± 17.6), Hip Outcome Score–Sport-Specific Subscale (39.6 ± 25.1 vs 30.5 ± 22.1), and visual analog scale (5.8 ± 1.8 vs 6.2 ± 2.2). At follow-up, the revision repair group had significantly higher mHHS (84.1 ± 14.8 vs 72.0 ± 18.3, P = .043) and iHOT-12 (72.2 ± 23.3 vs 49.0 ± 27.6, P = .023) scores than the reconstruction group. The magnitudes of pre- to postoperative improvement between the groups were comparable. The groups also had comparable rates of complications: 1 case of numbness in each group ( P > .999), subsequent arthroscopies (repair: n = 2, 6.5%; revision: n = 3, 20%; P = .150), and conversion to total hip arthroplasty (1 patient in each group, P > .999). Conclusion: Labral reconstruction safely and effectively treats irreparable labra in revision hip arthroscopy. However, labral repair is another treatment option for reparable labra, yielding similar magnitude of improvement. A proposed algorithm may assist in surgical decision making to achieve optimal outcomes based on the condition and history of each patient’s acetabular labrum.
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Brismar, Torkel B., Imre Janszky, and L. I. M. Toft. "Calcaneal BMD Obtained by Dual X-Ray and Laser Predicts Future Hip Fractures—A Prospective Study on 4 398 Swedish Women." Journal of Osteoporosis 2010 (2010): 1–6. http://dx.doi.org/10.4061/2010/875647.
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The predictive value of dual X-ray and laser (DXL) calcaneal BMD (BMDDXL) on hip fractures was prospectively studied in 4,398 females aged 55 to 99 years. The average follow-up period was 3 years and 11 months with a total of 17,270 person years. Fractures were identified from the national patient register. After inclusion, 130 females sustained a hip fracture. The age adjusted hazard ratio for T-score <−2.5 versus >−2.5 was 2.64. Of all patients who sustained a hip fracture 78% had a T-score of −2.5 or below. The annual hip fracture rate was 0.26% at T-scores ≥−2, but 1.5% at T-scores ≤−2.5. The area under curve for the model including calcanealBMDDXL, follow-up time, and age to prospectively predict hip fractures was 0.84.Conclusions. CalcanealBMDDXLobtained by DXL Calscan predicts hip fractures and may therefore be suitable for diagnosing osteoporosis and for predicting fracture risk.
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Chen, Austin W., Matthew J. Craig, Leslie C. Yuen, Victor Ortiz-Declet, David R. Maldonado, and Benjamin G. Domb. "Five-Year Outcomes and Return to Sport of Runners Undergoing Hip Arthroscopy for Labral Tears With or Without Femoroacetabular Impingement." American Journal of Sports Medicine 47, no. 6 (2019): 1459–66. http://dx.doi.org/10.1177/0363546519836429.
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Background: Recent evidence has demonstrated a high rate of return to running after hip arthroscopy for femoroacetabular impingement at short-term follow-up. The midterm outcomes and rates of continued running of these patients are unknown. Purpose: To evaluate midterm rates of return to running and outcomes after hip arthroscopy. Study Design: Case series; Level of evidence, 4. Methods: Data were prospectively collected for patients who underwent hip preservation surgery between July 2008 and November 2011. Patients were excluded for preoperative Tönnis osteoarthritis grade ≥2, previous ipsilateral hip conditions or hip surgery, or workers’ compensation status. All patients who participated in mid- to long-distance running before their surgery and intended on returning after their operation were considered for inclusion. Preoperative and minimum 5-year postoperative measures for the following patient-reported outcome scores (PROs) were necessary for inclusion in the final cohort: the modified Harris Hip Score, Non-arthritic Hip Score, Hip Outcome Score–Sports Specific Subscale, and visual analog scale (VAS) for pain. All patients were counseled about the risks of continued running after hip arthroscopy. Results: Sixty patients (62 hips) were eligible for inclusion, of which 50 (83.3%; 52 hips) had minimum 5-year follow-up. There were 10 male hips and 42 female hips. Mean ± SD age at surgery was 32.4 ± 12.4 years (range, 14.9-62.4), and mean body mass index was 22.9 ± 3.2 (range, 17.7-30.1). Latest follow-up was recorded at a mean 69.3 ± 8.5 months (range, 60.0-92.1 months). Level of competition included 39 recreational, 7 high school, 4 collegiate, and 2 professional athletes. There were significant improvements in all PROs and VAS scores preoperatively to latest follow-up. Mean modified Harris Hip Score improved from 67.5 to 88.2; mean Non-arthritic Hip Score, from 65.9 to 88.3; mean Hip Outcome Score–Sports Specific Subscale, from 49.5 to 81.0; and mean VAS, from 5.2 to 1.5. At latest follow-up, patient satisfaction was 8.4. Thirty-nine patients (78.0%, 41 hips) had returned to running postoperatively. When stratified by level of competition, 79% (31 of 39) of recreational, 100% (7 of 7) of high school, 50% (2 of 4) of collegiate, and 50% (1 of 2) of professional athletes returned to running. Conclusion: Hip arthroscopy for all levels of runners is associated with a significant increase in PROs and a low risk of complications. The rate of return to running is moderately high after hip arthroscopy at midterm follow-up. Hip arthroscopy may be considered for runners presenting with symptoms of femoroacetabular impingement that fail nonoperative treatments. Patients should be educated on the rate of return to running over time and the risks of continued running after hip arthroscopy.
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Scholes, Mark J., Matthew G. King, Kay M. Crossley, et al. "The Validity, Reliability, and Responsiveness of the International Hip Outcome Tool–33 (iHOT-33) in Patients With Hip and Groin Pain Treated Without Surgery." American Journal of Sports Medicine 49, no. 10 (2021): 2677–88. http://dx.doi.org/10.1177/03635465211027180.
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Background: The International Hip Outcome Tool–33 (iHOT-33) was developed to evaluate patients seeking surgery for hip and/or groin (hip/groin) pain and may not be appropriate for those seeking nonsurgical treatment. Purpose: To evaluate the psychometric properties of the iHOT-33 total (iHOT-Total) score and all subscale scores in adults with hip/groin pain who were not seeking surgery. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: Patients with hip/groin pain who were not seeking surgery were recruited from 2 ongoing studies in Australia. Semistructured one-on-one interviews assessed content validity. Construct validity was assessed by testing hypothesized correlations between iHOT-33 and Copenhagen Hip and Groin Outcome Score (HAGOS) subscale scores. Test-retest reliability was assessed in patients not undertaking treatment and who reported “no change” in their Global Rating of Change (GROC) score at 6-month follow-up. Scores were reliable at group and individual levels if intraclass correlation coefficients (ICCs) were ≥0.80 and ≥0.90, respectively. Scores were responsive if Spearman rank correlations (ρ) between the change in the iHOT-33 score and the GROC score were ≥0.40. Results: In total, 278 patients with hip/groin pain (93 women; mean age, 31 years) and 55 pain-free control participants (14 women; mean age, 29 years) were recruited. The iHOT-33 demonstrated acceptable content validity. Construct validity was acceptable, with all hypothesized strong positive correlations between iHOT-33 and HAGOS subscale scores confirmed ( r range, 0.60-0.76; P < .001), except for one correlation between the iHOT-Sport and HAGOS-Sport ( r = .058; P < .001). All scores were reliable at the group level, except for the iHOT-33 job subscale (iHOT-Job) (ICC range, 0.78-0.88 [95% CI, 0.60-0.93]). None of the subscales met the criteria for adequate reliability for use at the individual level (all ICCs <0.90). Minimal detectable change values (group level) ranged from 2.3 to 3.7 (95% CI, 1.7-5.0). All iHOT-33 subscale scores were responsive (ρ range, 0.40-0.58; P≤ .001), except for the iHOT-Job in patients not undertaking treatment (ρ = 0.27; P = .001). Conclusion: All iHOT-33 subscale scores were valid for use in patients with hip/groin pain who were not seeking surgery. Acceptable test-retest reliability was found for all subscale scores at the group level, except the iHOT-Job. All subscale scores, excluding the iHOT-Job, were responsive, regardless of undertaking physical therapist–led treatment or no treatment.
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Nilsdotter, Anna, and Ann Bremander. "Measures of hip function and symptoms: Harris Hip Score (HHS), Hip Disability and Osteoarthritis Outcome Score (HOOS), Oxford Hip Score (OHS), Lequesne Index of Severity for Osteoarthritis of the Hip (LISOH), and American Academy of Orthopedic Surgeons (A." Arthritis Care & Research 63, S11 (2011): S200—S207. http://dx.doi.org/10.1002/acr.20549.
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Christensen, Christian P., Peter L. Althausen, Murray A. Mittleman, Jo-ann Lee, and Joseph C. McCarthy. "The Nonarthritic Hip Score: Reliable and Validated." Clinical Orthopaedics and Related Research 406 (January 2003): 75–83. http://dx.doi.org/10.1097/00003086-200301000-00013.
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Hoeksma, Hugo L. "De Harris Hip Score in de fysiotherapiepraktijk." Stimulus 24, no. 2 (2005): 114–17. http://dx.doi.org/10.1007/bf03076129.
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Paz, Gabriel Andrade, Haroldo Gualter Santana, Francine de Oliveira, et al. "The relationship between y balance performance and hip strength in recreationally trained women." Research, Society and Development 10, no. 10 (2021): e327101019167. http://dx.doi.org/10.33448/rsd-v10i10.19167.
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This study set one´s sight on the relationship between lower quarter y balance test (YBT-LQ) score with hip isometric strength with recreationally resistance-trained women. Utilizing dynamic balance as a screening tool for lower extremity injury risk has been proposed as a potential solution in injury prevention and injury assessment. A convenience sample of twenty young college females (22.3 ± 2.1 years) with a background in regular strength or plyometric training volunteered to participate in this study. The scores of YBT-LQ for each direction were calculated. A hand-held dynamometer was used to measure the maximum voluntary isometric strength of each participant´s unilateral hip extensors, flexors, adductors, abductors, internal and external rotation muscles. Significant lower normalized score was noted for the dominant limb (81.2 ± 11.7) when compared to non-dominant limb (83.6 ± 12.4) for anterior distance. For the composite score of YBT-LQ, a weak association was noted for hip extension and internal rotation, and moderate association was observed for hip flexion, adduction, and abduction. On the other hand, a strong association was observed between hip external rotators strength (r =0.516). Thus, the main finding of the current study was the strong association observed between hip external rotators strength and composite score of YBT-LQ.
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Boschi, A., P. Planche, A. Philippe, and L. Vaivre-douret. "Assessment of cognitive profile (WISC-IV), autistic symptomatology and pragmatic disorders in high intellectual potential compared with autism spectrum disorder." European Psychiatry 33, S1 (2016): S129. http://dx.doi.org/10.1016/j.eurpsy.2016.01.184.
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IntroductionAn overlap between autism spectrum disorder (ASD), in particular Asperger Syndrome (AS), and high intellectual potential (HIP–Total IQ > 2 SD) is often discussed.ObjectivesExplore differences between homogeneous and heterogeneous Wisc-profiles among HIP children, and between HIP and ASD children, on cognitive and clinical assessments.MethodsForty-nine participants (mean age 11.2 years) were divided in 4 groups: High Functioning Autism (HFA), AS, Homogenous HIP and Heterogeneous HIP. Data of WISC-IV and questionnaires – Autism Quotient (AQ), Empathy Quotient (EQ), Systemizing Quotient (SQ), Children's Communication Checklist (CCC) – were compared.(Preliminary) ResultsOn the WISC-IV, the Z scores curves follow similar trajectories but highlight quantitative differences between AS and heterogeneous HIP: verbal comprehension is the highest index (+1,6 SD in AS; +3,1 SD in heterogeneous HIP) followed by perceptual reasoning, working memory, and processing speed indexes (–1,2 SD in AS; +0,5 SD in heterogeneous HIP), respectively. The questionnaires show that scores of Homogenous HIP children are all in the average. Heterogeneous HIP children score 2,1 SD above average on the AQ (+1,6 SD on “Social Skills” and +1,3 SD on “Local Detail” subscales), whereas ASD children score 4 SD above average on the AQ. In addition, heterogeneous HIP children show pragmatic difficulties (–2,4 SD on the CCC, with a peak on “Area of Interest” subscale), also present in ASD children (–4 SD).ConclusionsAS and heterogeneous HIP children show similar cognitive profiles on the WISC-IV. Furthermore, heterogeneous HIP children exhibit high scores on the AQ and have pragmatic difficulties.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Ebert, Jay R., Anne Smith, William Breidahl, Michael Fallon, and Gregory C. Janes. "Association of Preoperative Gluteal Muscle Fatty Infiltration With Patient Outcomes in Women After Hip Abductor Tendon Repair Augmented With LARS." American Journal of Sports Medicine 47, no. 13 (2019): 3148–57. http://dx.doi.org/10.1177/0363546519873672.
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Background: Hip abductor tendon repair has demonstrated encouraging outcomes. The influence of fatty infiltration (FI) on outcome has not been explored. Purpose: To investigate the association between preoperative hip abductor FI and clinical outcome after hip abductor tendon repair. Study Design: Case series; Level of evidence, 4. Methods: A total of 84 women underwent hip abductor tendon repair. The mean age was 64.6 years (range, 43-84 years); body mass index, 27.7 (range, 20.0-40.2); and duration of symptoms, 3.4 years (range, 6 months–20 years). The 6-minute walk test, isometric hip abduction strength assessment, and patient-reported outcome measures, including the Harris Hip Score and Oxford Hip Score, were completed presurgery and 2 years after surgery. Patient satisfaction and perceived improvement were assessed 2 years after surgery. All patients underwent preoperative magnetic resonance imaging on the affected hip, and the Goutallier system was used to grade the degree of FI in the anterior, middle, and posterior thirds of the gluteus medius and minimus on a 0-4 ordinal scale. A single FI score for the gluteus medius and minimus was calculated, as was a combined FI score. Results: All clinical scores significantly improved over time ( P < .001). Preoperatively, FI was more severe in the gluteus minimus, with the most severe FI (grades 2-4) demonstrated in the middle (n = 56, 66.7%) and anterior (n = 17, 20.2%) portions of the gluteus minimus and the middle (n = 27, 32.1%) and anterior (n = 12, 14.3%) portions of the gluteus medius. Older age was associated with greater FI (combined FI score: r = 0.529, P < .001), although duration of symptoms ( r = 0.035, P = .753) and body mass index ( r = 0.089, P = .464) were not. Greater FI was associated with less improvement in hip strength of the unaffected leg (coefficient, –1.6, 95% CI: −2.8 to −0.4), although no other significant associations were observed between FI and pre- or postoperative clinical scores. Conclusion: Preoperative FI was not associated with pertinent parameters of patient outcome after hip abductor tendon repair, including pain, symptoms, functional capacity, perceived improvement, and satisfaction. Based on these outcomes, surgical repair may be considered in the presence of more severe FI.
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Poulsen, Ninna R., Inger Mechlenburg, Kjeld Søballe, and Jeppe Lange. "Patient-reported quality of life and hip function after 2-stage revision of chronic periprosthetic hip joint infection: a cross-sectional study." HIP International 28, no. 4 (2017): 407–14. http://dx.doi.org/10.5301/hipint.5000584.
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Introduction: Very limited information is available regarding patient-reported health-related quality of life (HRQoL) and hip function following treatment for chronic periprosthetic hip joint infection (PJI). Patient-reported outcome measures provide essential information to clinicians of the impact a treatment have on patient’s lives. The purpose of this study was to examine patient reported HRQoL and hip function after a completed re-implantation in a 2-stage revision. Method: 82 patients were identified retrospectively in the National Patient Register. 57 patients were alive and asked to complete the questionnaires EuroQol-5D (EQ-5D) and Oxford Hip Score (OHS) in November 2014. Results were compared to normative population data for EQ-5Dindex. Patients re-infected after a completed 2-stage revision were compared with not re-infected. Results: 45 patients completed the questionnaires. Mean time since re-implantation was 8.2 years (95% CI [confidence interval], 7.7-0.87). The EQ-5D index mean for the 2-stage group was 0.71 (0.64; 0.77) whereas the general population mean is 0.85 (0.84-0.85), p = 0.0004. The 2-stage revision patients scored significantly lower on every EQ-5D dimension. The re-infected group mean EQ-5D index score was significantly lower compared to the not re-infected group, p = 0.003. The EQ-VAS mean score was 58.2 (57.3-68.3) and the mean OHS for the group was 29.2 (25.4-33.0). Conclusions: Patients who undergo 2-stage revision after a PJI have lower scores on HRQoL than the general population. Patients who are re-infected following revision have a lower HRQoL score than patients not re-infected. Future research should focus on optimising patient-reported outcomes after treatment for PJI.
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Domb, Benjamin G., Timothy J. Martin, Chengcheng Gui, Sivashankar Chandrasekaran, Carlos Suarez-Ahedo, and Parth Lodhia. "Predictors of Clinical Outcomes After Hip Arthroscopy: A Prospective Analysis of 1038 Patients With 2-Year Follow-up." American Journal of Sports Medicine 46, no. 6 (2018): 1324–30. http://dx.doi.org/10.1177/0363546518763362.
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Background: As hip arthroscopy has expanded in popularity and volume, more information is needed about indications for the procedure and the predictive factors of clinical outcomes. Purpose: To evaluate clinical outcomes of hip arthroscopy in a prospective study and to analyze the cohort to identify factors that are predictive of improvement. Study Design: Case-control study; Level of evidence, 3. Methods: Data were collected prospectively on all patients undergoing hip arthroscopy between February 2008 and June 2012. We included all patients undergoing hip arthroscopy who agreed to participate and who completed 4 patient-reported outcome (PRO) instruments at a minimum 2-year follow-up: the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Score–Activities of Daily Living (HOS-ADL), and Hip Outcome Score–Sport-Specific Subscale. The NAHS was selected as our primary outcome instrument. All patients with any previous hip conditions were excluded. We analyzed 34 preoperative and intraoperative variables using bivariate and multivariate analyses compared with NAHS. Results: The cohort consisted of 1038 patients with a mean follow-up of 30.1 months (range, 24.0-61.2 months). Mean age was 36.4 years (range, 13.2-76.4 years). All postoperative PRO scores showed significant improvement ( P < .001) at 2 years compared with preoperative scores. Bivariate analysis identified 15 variables (7 categorical and 8 continuous) and multivariate analysis identified 10 variables that were predictive of 2-year postoperative NAHS. Preoperative NAHS, preoperative HOS-ADL, preoperative mHHS, age, duration of symptoms, body mass index (BMI), and revision hip arthroscopy were identified as predictive factors in both bivariate and multivariate analyses. The predictive value of preoperative NAHS was accentuated for patients with higher BMI. Conclusion: This study reports favorable clinical outcomes in the largest cohort of hip arthroscopies with a minimum 2-year follow-up in the literature to date. Factors identified as predictive in both bivariate and multivariate analyses included preoperative NAHS, HOS-ADL, and mHHS; age; duration of symptoms; BMI; and revision hip arthroscopy. These predictive factors may be useful to the clinician in determining prognosis and operative indications for hip arthroscopy.
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Sanchis-Alfonso, Vicente, Marc Tey, and Joan Carles Monllau. "A Novel Association between Femoroacetabular Impingement and Anterior Knee Pain." Pain Research and Treatment 2015 (September 14, 2015): 1–4. http://dx.doi.org/10.1155/2015/937431.
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Background. For a long time it has been accepted that the main problem in the anterior knee pain (AKP) patient is in the patella. Currently, literature supports the link between abnormal hip function and AKP. Objective. Our objective is to investigate if Cam femoroacetabular impingement (FAI) resolution is related to the outcome in pain and disability in patients with chronic AKP recalcitrant to conservative treatment associated with Cam FAI. Material and Methods. A retrospective study on 7 patients with chronic AKP associated with FAI type Cam was performed. Knee and hip pain were measured with the visual analogue scale (VAS), knee disability with the Kujala scale, and hip disability with the Nonarthritic Hip Score (NAHS). Results. The VAS knee pain score and VAS hip pain score had a significant improvement postoperatively. At final follow-up, there was significant improvement in all functional scores (Kujala score and NAHS). Conclusion. Our finding supports the link between Cam FAI and AKP in some young patients. Assessment of Cam FAI should be considered as a part of the physical examination of patients with AKP, mainly in cases with pain recalcitrant to conservative treatment.
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Nwachukwu, Benedict U., Edward C. Beck, Elaine K. Lee, et al. "Application of Machine Learning for Predicting Clinically Meaningful Outcome After Arthroscopic Femoroacetabular Impingement Surgery." American Journal of Sports Medicine 48, no. 2 (2019): 415–23. http://dx.doi.org/10.1177/0363546519892905.
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Background: Hip arthroscopy has become an important tool for surgical treatment of intra-articular hip pathology. Predictive models for clinically meaningful outcomes in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS) are unknown. Purpose: To apply a machine learning model to determine preoperative variables predictive for achieving the minimal clinically important difference (MCID) at 2 years after hip arthroscopy for FAIS. Study Design: Case-control study; Level of evidence, 3. Methods: Data were analyzed for patients who underwent hip arthroscopy for FAIS by a high-volume fellowship-trained surgeon between January 2012 and July 2016. The MCID cutoffs for the Hip Outcome Score–Activities of Daily Living (HOS-ADL), HOS–Sport Specific (HOS-SS), and modified Harris Hip Score (mHHS) were 9.8, 14.4, and 9.14, respectively. Predictive models for achieving the MCID with respect to each were built with the LASSO algorithm (least absolute shrinkage and selection operator) for feature selection, followed by logistic regression on the selected features. Study data were analyzed with PatientIQ, a cloud-based research and analytics platform for health care. Results: Of 1103 patients who met inclusion criteria, 898 (81.4%) had a minimum of 2-year reported outcomes and were entered into the modeling algorithm. A total of 74.0%, 73.5%, and 79.9% met the HOS-ADL, HOS-SS, and mHHS threshold scores for achieving the MCID. Predictors of not achieving the HOS-ADL MCID included anxiety/depression, symptom duration for >2 years before surgery, higher body mass index, high preoperative HOS-ADL score, and preoperative hip injection (all P < .05). Predictors of not achieving the HOS-SS MCID included anxiety/depression, preoperative symptom duration for >2 years, high preoperative HOS-SS score, and preoperative hip injection, while running at least at the recreational level was a predictor of achieving HOS-SS MCID (all P < .05). Predictors of not achieving the mHHS MCID included history of anxiety or depression, high preoperative mHHS score, and hip injections, while being female was predictive of achieving the MCID (all P < .05). Conclusion: This study identified predictive variables for achieving clinically meaningful outcome after hip arthroscopy for FAIS. Patient factors including anxiety/depression, symptom duration >2 years, preoperative intra-articular injection, and high preoperative outcome scores are most consistently predictive of inability to achieve clinically meaningful outcome. These findings have important implications for shared decision-making algorithms and management of preoperative expectations after hip arthroscopy for FAI.
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Hartigan, David E., Itay Perets, John P. Walsh, Edwin O. Chaharbakhshi, Leslie C. Yuen, and Benjamin G. Domb. "Clinical Outcomes of Hip Arthroscopic Surgery in Patients With Femoral Retroversion: A Matched Study to Patients With Normal Femoral Anteversion." Orthopaedic Journal of Sports Medicine 5, no. 10 (2017): 232596711773272. http://dx.doi.org/10.1177/2325967117732726.
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Background: Femoral retroversion has been noted as a possible risk factor for poor clinical results after hip arthroscopic surgery. Purpose: To compare the outcomes of the arthroscopic treatment of hip abnormalities in patients with femoral retroversion to patients with femoral anteversion between 10° and 20°. Study Design: Cohort study; Level of evidence, 3. Methods: Between November 2011 and September 2013, 790 hip arthroscopic procedures were performed at a single institution. Of these, 59 hips (7.5%) were located in patients with femoral version ≤0°, calculated using preoperative magnetic resonance imaging. These patients were pair matched, based on body mass index ±5 kg/m2, age ±5 years, and Tönnis grade, with 59 patients with femoral anteversion between 10° and 20°. Exclusion criteria included Perthes disease, inflammatory arthritis, slipped capital femoral epiphysis, previous hip surgery, abductor repair, lateral center-edge angle <20°, Tönnis grade >1, and acetabular profunda or protrusio. Patient-reported outcomes (PROs) were recorded preoperatively, at 3 months postoperatively, and annually thereafter. The PROs utilized were the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), and Hip Outcome Score–Sports-Specific Subscale (HOS-SSS). The visual analog scale (VAS) was collected to assess the patients’ pain; patient satisfaction scores (0-10) were also collected. Radiographs were collected at the above time intervals as well. Results: Two patients from the control group and 1 patient from the retroverted group required total hip arthroplasty at a mean 19.5 and 26.3 months, respectively. Both groups demonstrated significant improvement from their preoperative state in all PRO and VAS scores ( P < .001). No differences in preoperative, postoperative, or change in PRO and VAS scores between the groups were noted. Conclusion: Patients with femoral retroversion reported similar outcomes compared to patients with normal femoral version when undergoing hip arthroscopic surgery. Both groups had similar improvements from the preoperative state.
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Domb, Benjamin, Cynthia Kyin, Jacob Shapira, David Maldonado, Ajay Lall, and Philip Rosinsky. "Return to Sport Rates and Functional Outcomes Following Bilateral Hip Arthroscopy in High-Level Athletes." Orthopaedic Journal of Sports Medicine 8, no. 7_suppl6 (2020): 2325967120S0043. http://dx.doi.org/10.1177/2325967120s00435.
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Objectives: To determine the rate of return to sport (RTS) in high-level athletes undergoing bilateral hip arthroscopy and report minimum 1-year patient-reported outcomes (PROs) for this cohort. We hypothesized that RTS rates, as well as sport-specific PROs, will be lower than the rates and scores previously reported in the literature for unilateral hip arthroscopy. Methods: Data were prospectively collected on all patients undergoing hip arthroscopy at our institution from November 2011 to July 2018. Patients were included if they underwent bilateral hip arthroscopy and were either a high school, collegiate, or professional athlete prior to their first surgery. RTS was defined as a patient’s return to competitive participation in their respective sport. Additional PROs, including modified Harris Hip Score (mHHS), nonarthritic hip score (NAHS), and Hip Outcome Score-Sports Specific Subscale (HOS-SSS), as well as complication rates and future surgeries were documented and compared for all patients. Results: A total of 87 patients met inclusion criteria, for which follow-up was available for 82 (94.3%). At latest follow-up, 44 (53.7%) patients returned to sport. Of patients returning, 56% did so at the same level or higher. The most common reasons for not returning to sport were due to graduation/lifestyle change (47.4%) and hip symptoms (44.7%). Patients returning to sport had significantly higher PROs at latest follow-up relative to those who did not return, including for mHHS (93.7 vs. 87.5), NAHS (94.4 vs. 88.2), HOS-SSS (90.9 vs. 78.2) (P < 0.05). Rates of achieving PASS and MCID for mHHS were not significantly different. However, for HOS-SSS, patients who returned had significantly higher rates of achieving the MCID and PASS. Conclusion: Rates of RTS after bilateral hip arthroscopy are lower than those after unilateral hip arthroscopy. When comparing patients that returned to sports and those who did not return, we show that although both groups show a significant improvement in PROs following surgery, those that returned to sport achieved significantly higher scores in all outcome measures. In addition, patients returning to sports showed a significantly higher rate of attaining MCID and PASS scores for the HOS-SSS, possibly attesting to the validity of this score and its thresholds.
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Heaps, Braiden M., Jacob D. Feingold, Erica Swartwout, et al. "Lumbosacral Transitional Vertebrae Predict Inferior Patient-Reported Outcomes After Hip Arthroscopy." American Journal of Sports Medicine 48, no. 13 (2020): 3272–79. http://dx.doi.org/10.1177/0363546520961160.
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Background: While the association between spinal disease and hip arthroplasty outcomes has been well studied, there is less known about the effect of spinal pathology in hip arthroscopy (HA) outcomes. Lumbosacral transitional vertebrae (LSTV) are anatomic variations where caudal vertebrae articulate or fuse with the sacrum or ilium. Hypothesis: LSTV can lead to inferior outcomes after HA for treatment of femoroacetabular impingement. Study Design: Cohort study; Level of evidence, 3. Methods: We retrospectively reviewed the prospectively collected Hip Arthroscopy Database at our institution for patients with LSTV who underwent HA between 2010 and 2017. A total of 62 patients with LSTV were identified and then matched to controls. Patient-reported outcome measures (PROMs) were collected, including the modified Harris Hip Score, Hip Outcome Score–Activities of Daily Living, Hip Outcome Score–Sports, and the 33-item International Hip Outcome Tool. They were collected at 4 time points: preoperatively and 5 to 11 months, 12 to 23 months, and 24 to 35 months postoperatively. Longitudinal analysis of the PROMs was done using generalized estimating equation modeling. Additionally, alpha angles were measured from preoperative radiographic data. Results: Preoperatively, there was no significant difference between patients with and without LSTV on 3 of the 4 PROMs; however, patients with LSTV did have significantly lower preoperative scores than controls for the Hip Outcome Score–Activities of Daily Living ( P = .029). Patients with LSTV reported significantly lower scores on all 4 PROMs at each postoperative time point. Radiographic data showed no significant difference in alpha angles across cohorts. When LSTV were compared by Castellvi type, types 3 and 4 tended to have lower scores than types 1 and 2; however, these comparisons were not significant. Conclusion: The data support our hypothesis that HA has less benefit in patients with LSTV as compared with patients without LSTV. In patients with LSTV, careful evaluation of the anomaly is recommended to help guide surgical counseling and manage expectations.
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Atzmon, Ran, Zachary T. Sharfman, Barak Haviv, et al. "Does capsular closure influence patient-reported outcomes in hip arthroscopy for femoroacetabular impingement and labral tear?" Journal of Hip Preservation Surgery 6, no. 3 (2019): 199–206. http://dx.doi.org/10.1093/jhps/hnz025.
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Abstract Capsulotomy is necessary to facilitate instrument manoeuvrability within the joint capsule in many arthroscopic hip surgical procedures. In cases where a clear indication for capsular closure does not exist, surgeon’s preference and experience often determines capsular management. The purpose of this study was to assess the influence of capsular closure on clinical outcome scores and satisfaction in patients who underwent hip arthroscopy surgery for femoroacetabular impingement (FAI) and labral tear. Data were prospectively collected and retrospectively analysed for hip arthroscopy surgeries with a minimum 2 years follow-up. Patients with developmental dysplasia of the hip, previous back or hip surgeries, and degenerative changes to this hip and secondary gains were excluded. Demographic data, intraoperative findings and patient-reported outcome scores were recorded, including the Modified Harris Hip Score (MHHS) and Hip Outcome Score (HOS). A total of 29 and 35 patients were included in the non-closure and closure groups, respectively. The mean follow-up time was over 3 years for both groups. The mean pre-operative and post-operative HOS scores and MHHS scores did not significantly differ between groups (pre-operative HOS: 65.6 and 66.3, P = 0.898; post-operative HOS: 85.4 and 87.2, P = 0.718; pre-operative MHHS: 63.2 and 58.4, P = 0.223; post-operative MHHS: 85.7 and 88.7, P = 0.510). Overall patient satisfaction did not differ significantly between groups (non-closure 86.3%, closure group 88.6%; P = 0.672). Capsular closure did not significantly influence satisfaction or clinical outcome scores in patients who underwent arthroscopic hip surgery for FAI or labral tear.
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Shaikh, Abdul Malik, Muhammad Bakhsh Shahwani, and Mohammad Ishaq. "HIP FRACTURE." Professional Medical Journal 25, no. 01 (2018): 30–33. http://dx.doi.org/10.29309/tpmj/2018.25.01.533.
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Objectives: To compare mean pain score between skin traction versus withoutskin traction in cases presenting with hip fracture. Study Design: Multi-randomized controlledstudy. Setting: Department of Orthopaedics, Chandka Medical College Hospital Larkana andQazi Hussain Ahmad Medical Complex, Nowshera. Period: 1st October 2016 to 31st March2017. Materials and Methods: A total of 100 cases (50 in two groups) between 18-60 years ofage including both genders presenting with unilateral femur fracture within 72 hours of injurywere enrolled in this study. They were divided in two groups i.e. study and control group, studygroup was allotted to the cases undergoing traction while control was those without using skintraction. Intramuscular diclofenac sodium injection (75 gm) was used in all participants andfollowed up for two tablets of paracetamol (500 mg) on 8 hourly basis. Visual analogue scaleto record pain score, 0 was no pain and 10 was the severe pain, it was recorded at 24 hoursof application of traction and second measurement was recorded just few minutes before thesurgery is done. Results: In this study, mean age was calculated as 48.74+9.12 years, agerange was 18-60 years. Male participants were in majority by calculating 64% (n=32) in Studyand 58% (n=29) in control group while female cases were 36% (n=18) in cases and 42%(n=21) in control group. Mean pain score at 24 hours of traction in study and control group wasrecorded as 4.60+0.70 in study group and 5.30+0.82 in control group (P = 0.0553), showsa significant difference. Conclusion: Mean pain score is significantly reduced during first 24hours of application of skin traction as compared to those without it in cases with hip fractures,however, it has no significant effect on pain after 24 hours of application.
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Kawai, Toshiyuki, Koji Goto, Yutaka Kuroda, and Shuichi Matsuda. "Lower Activity and Function Scores Are Associated with a Higher Risk of Preoperative Deep Venous Thrombosis in Patients Undergoing Total Hip Arthroplasty." Journal of Clinical Medicine 9, no. 5 (2020): 1257. http://dx.doi.org/10.3390/jcm9051257.
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This study was performed to investigate the relationship between patients’ activity and function levels and the incidence of preoperative deep venous thrombosis (DVT) prior to total hip arthroplasty (THA). We retrospectively reviewed 500 patients admitted for primary or revision THA from July 2014 to October 2018. The diagnosis of DVT was confirmed using Doppler ultrasonography 1 month before THA. The patients’ activity and hip function were evaluated using several clinical scores: the Harris Hip Score (HHS), Oxford Hip Score (OHS), University of California Los Angeles (UCLA) activity score, and visual analog scale (VAS) score. Those scores and the medical history were examined for correlations with preoperative DVT using univariate and multivariate models. Univariate regression analysis showed that older age, current steroid use, anticoagulant use, a history of DVT, collagen disease, a lower UCLA activity score, and a lower OHS were associated with an elevated risk of preoperative DVT. The multivariate analyses showed that a higher UCLA activity score (odds ratio (OR): 0.0049–0.012) and higher OHS (OR: 0.0012–0.0088) were associated with a lower risk of preoperative DVT in each model. Age (OR: 1.07 in both models), current steroid use (OR: 9.32–10.45), and a history of DVT (OR: 27.15–74.98) were associated with a higher risk of preoperative DVT in both models. Older age, current steroid use, a history of DVT, a lower UCLA activity score, and a lower OHS were risk factors for preoperative DVT before THA, even when controlling for potential confounders. Patients exhibiting low activity and low function levels were more likely to have DVT, even before surgery.
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Domb, Benjamin G., Edwin O. Chaharbakhshi, Itay Perets, Leslie C. Yuen, John P. Walsh, and Lyall Ashberg. "Hip Arthroscopic Surgery With Labral Preservation and Capsular Plication in Patients With Borderline Hip Dysplasia: Minimum 5-Year Patient-Reported Outcomes." American Journal of Sports Medicine 46, no. 2 (2017): 305–13. http://dx.doi.org/10.1177/0363546517743720.
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Background: The arthroscopic management of hip dysplasia has been controversial and has historically demonstrated mixed results. Studies on patients with borderline dysplasia, emphasizing the importance of the labrum and capsule as secondary stabilizers, have shown improvement in patient-reported outcomes (PROs). Purpose/Hypothesis: The purpose was to assess whether the results of hip arthroscopic surgery with labral preservation and concurrent capsular plication in patients with borderline hip dysplasia have lasting, positive outcomes at a minimum 5-year follow-up. It was hypothesized that with careful patient selection, outcomes would be favorable. Study Design: Case series; Level of evidence, 4. Methods: Data were prospectively collected and retrospectively reviewed for patients aged <40 years who underwent hip arthroscopic surgery for intra-articular abnormalities. Inclusion criteria included lateral center-edge angle (LCEA) between 18° and 25°, concurrent capsular plication and labral preservation, and minimum 5-year follow-up. Exclusion criteria were severe dysplasia (LCEA ≤18°), Tönnis grade ≥2, pre-existing childhood hip conditions, or prior hip surgery. PRO scores including the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), and Hip Outcome Score Sport-Specific Subscale (HOS-SSS) and the visual analog scale (VAS) score for pain were collected preoperatively, at 3 months, and annually thereafter. Complications and revisions were recorded. Results: Twenty-five hips (24 patients) met the inclusion criteria. Twenty-one hips (19 patients, 84%) were available for follow-up. The mean age at surgery was 22.9 years. The mean preoperative LCEA and Tönnis angle were 21.7° (range, 18° to 24°) and 6.9° (range, –1° to 16°), respectively. The mean follow-up was 68.8 months. The mean mHHS increased from 70.3 to 85.9 ( P < .0001), the mean NAHS from 68.3 to 87.3 ( P < .0001), and the mean HOS-SSS from 52.1 to 70.8 ( P = .0002). The mean VAS score improved from 5.6 to 1.8 ( P < .0001). Four hips (19%) required secondary arthroscopic procedures, all of which resulted in improved PRO scores at latest follow-up. No patient required conversion to total hip arthroplasty. Conclusion: While periacetabular osteotomy remains the standard for treating true acetabular dysplasia, hip arthroscopy may provide a safe and durable means of managing intra-articular abnormalities in the setting of borderline acetabular dysplasia at midterm follow-up. These procedures should be performed by surgeons with expertise in advanced arthroscopic techniques, using strict patient selection criteria, with emphasis on labral preservation and capsular plication.
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Aprato, Alessandro, Narlaka Jayasekera, and Richard N. Villar. "Does the Modified Harris Hip Score Reflect Patient Satisfaction After Hip Arthroscopy?" American Journal of Sports Medicine 40, no. 11 (2012): 2557–60. http://dx.doi.org/10.1177/0363546512460650.
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Background: No published studies have explored the relationship between commonly reported clinical outcomes and patient satisfaction after hip arthroscopy. Purpose: To compare the modified Harris Hip Score (mHHS) with patient satisfaction in a prospective study over a 2-year period. Study Design: Case series; Level of evidence, 4. Methods: We reviewed our institutional database for prospectively collected mHHS and patient satisfaction data from 697 patients. Patients were evaluated preoperatively and at 1 and 2 years after surgery. Results: The mHHS correlated with patient satisfaction at 1 year ( P < .001, Pearson R = 0.451) and at 2 years ( P < .001, Pearson R = .454). Considering scores from excellent to good as positive results and from fair to poor as negative results, sensitivity was 73% at 1 year and 77% at 2 years. Respectively, the specificity was 64% and 73%, positive predictive value 86% and 91%, negative predictive value 45% and 46%, and accuracy 71% and 76%. At 1- and 2-year follow-up, a respective 55% and 54% of patients with fair to poor mHHS were satisfied with the outcome of hip arthroscopy. In contrast, for those patients with an excellent to good mHHS at 1 and 2 years after surgery, 14% and 9%, respectively, were dissatisfied with their outcome. Conclusion: Our results show a correlation between patient satisfaction and the mHHS but also demonstrate a limitation of the mHHS as an outcome measure in the prediction of patient satisfaction. Further investigation is required to assess factors beyond current standard orthopaedic clinical outcome measures that may influence patient satisfaction after hip arthroscopy.