P197 - Does Failure to Meet Threshold Scores for mHHS and iHOT-12 Correlate to Reoperations Following Hip Arthroscopy?
Abstract
Purpose
To determine: (a) if failing to achieve a patient reported outcome (PRO) threshold at 1-year could predict reoperations at minimum 2-year follow up and (b) to find the relative risk (RR) of reoperation in patients who do not achieve certain PRO thresholds.
Methods and Materials
Inclusion criteria for this study were patients who underwent primary hip arthroscopy between July 2014 and December 2016. Included patients had recorded pre-operative and post-operative modified Harris Hip Score (mHHS) and international Hip Outcome Tool – 12 item (iHOT-12) scores at 1-year follow-up, as well as documented reoperation surgery status at minimum 2 years. Patients were categorized based on their ability to achieve thresholds of minimal clinical important difference (MCID), substantial clinical benefit (SCB), and patient acceptable symptom state (PASS) for mHHS and iHOT-12. The sensitivity, specificity, accuracy, and relative risk of these thresholds as a predictor for reoperation was calculated.
Results
Of the 593 hips that met eligibility, 548 hips (92.4%) had complete follow-up. For mHHS, 418 (76.3%), 268 (48.9%), and 406 (74.1%) hips met MCID, SCB, and PASS, respectively. For iHOT-12, 432 (78.8%), 340 (62.0%), and 368 (67.2%) hips met the respective thresholds. The highest sensitivity, specificity, and accuracy were identified as the iHOT-12 PASS (0.64), iHOT-12 MCID (0.81), and iHOT-12 MCID (0.78), respectively. Modified Harris Hip Score PASS (RR = 4.11 CI95% = 2.24-7.55) was identified as having the highest RR, whereas SCB generally produced lower sensitivity, specificity, and accuracy.
Conclusion
In a novel approach of PRO threshold score utilization, this study identified patients at increased risk of reoperations following primary hip arthroscopy, notably those who do not achieve MCID or PASS for either mHHS or iHOT-12. The most accurate predictor of reoperation (0.78) was not achieving MCID of iHOT-12, while the highest RR for reoperation was not achieving PASS for mHHS (4.11).
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