Background:

The minimal clinically important difference (MCID), Patient Acceptable Symptom State (PASS), substantial clinical benefit (SCB), and maximum outcome improvement (MOI) satisfaction threshold for the Hip Outcome Score Sport-Specific Subscale (HOS-SSS) have not been established in athletes undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS).

Purpose:

To determine threshold MCID, PASS, SCB, and MOI satisfaction threshold values for the HOS-SSS in athletes undergoing hip arthroscopy for FAIS at minimum 2–year follow–up.

Study Design:

Cohort study (Diagnosis); Level of evidence, 3.

Methods:

Anchor questions were administered to recreational, organized amateur, high school, college, and professional athletes who underwent primary hip arthroscopy for FAIS between May 2015 and March 2019. Patients were included if they were younger than 50 years, answered the anchor questions, and had preoperative and minimum 2–year follow–up for the HOS-SSS, modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), and visual analog scale (VAS) for pain. Exclusion criteria were Tönnis grade >1, hip dysplasia (lateral center–edge angle <18°), and previous ipsilateral hip surgery or conditions. Receiver operating characteristic (ROC) analysis was used to determine PASS, SCB, and MOI satisfaction for the HOS-SSS. Two distribution methods were used to calculate MCID for HOS-SSS.

Results:

A total of 225 athletes who underwent primary hip arthroscopy met the inclusion criteria. Of those athletes, 200 (88.9%) who had minimum 2–year follow–up and information regarding return to sport (RTS) were included. The cohort included 124 (62.0%) women and 76 (38.0%) men with a mean ± standard deviation age of 29.4 ± 10.4 years, body mass index of 25.6 ± 5.4, and follow–up of 29.5 ± 5.1 months. Athletes experienced significant improvements in HOS-SSS, mHHS, NAHS, and VAS from preoperative to latest postoperative follow–up (P < .001), and mean satisfaction was 8.2. The RTS rate was 83.7%. ROC analysis determined that the PASS, MOI satisfaction threshold, SCB absolute score, SCB change score, and MCID (baseline/change score methods) for the HOS-SSS were 77.0, 44.6%, 92.7, 30.6, and 10.6, respectively, with athletes achieving thresholds at high rates (80.0%, 80.5%, 45.0%, 54.0%, and 79.5%, respectively).

Conclusion:

This study identified values for the HOS-SSS that can be used to define clinically meaningful outcomes in athletes after primary hip arthroscopy for FAIS. The PASS, MOI satisfaction threshold, SCB absolute score, SCB change score, and MCID for the HOS-SSS at minimum 2–year follow–up in athletes after primary hip arthroscopy were 77.0, 44.6%, 92.7, 30.6, and 10.6, respectively.

中文翻译：

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确定接受髋关节镜检查治疗股骨髋臼撞击综合征的运动员髋关节结果评分运动特定分量表的临床意义阈值

背景：

髋关节结果评分运动特定分量表 (HOS-SSS) 的最小临床重要差异 (MCID)、患者可接受症状状态 (PASS)、实质性临床益处 (SCB) 和最大结果改善 (MOI) 满意度阈值尚未确定建立在接受髋关节镜检查治疗股骨髋臼撞击综合征 (FAIS) 的运动员中。

目的：

在至少 2 年的随访中确定接受髋关节镜检查 FAIS 的运动员的 HOS-SSS 阈值 MCID、PASS、SCB 和 MOI 满意度阈值。

学习规划：

队列研究（诊断）；证据水平，3。

方法：

对 2015 年 5 月至 2019 年 3 月期间因 FAIS 接受初级髋关节镜检查的休闲、有组织的业余、高中、大学和专业运动员进行了锚定问题。如果患者年龄小于 50 岁，回答锚定问题，并且有HOS-SSS、改良 Harris 髋关节评分 (mHHS)、非关节炎髋关节评分 (NAHS) 和疼痛视觉模拟评分 (VAS) 的术前和至少 2 年随访。排除标准是 Tönnis 分级 >1、髋关节发育不良（外侧中心-边缘角 <18°）和既往同侧髋关节手术或疾病。接受者操作特征 (ROC) 分析用于确定 HOS-SSS 的 PASS、SCB 和 MOI 满意度。使用两种分布方法计算 HOS-SSS 的 MCID。

结果：

共有 225 名接受初次髋关节镜检查的运动员符合纳入标准。在这些运动员中，有 200 名 (88.9%) 进行了至少 2 年的随访和有关重返运动 (RTS) 的信息。该队列包括 124 名 (62.0%) 女性和 76 名 (38.0%) 男性，平均 ± 标准差年龄为 29.4 ± 10.4 岁，体重指数为 25.6 ± 5.4，随访时间为 29.5 ± 5.1 个月。从术前到最近的术后随访，运动员的 HOS-SSS、mHHS、NAHS 和 VAS 都有显着改善（P< .001)，平均满意度为 8.2。RTS率为83.7%。ROC 分析确定，HOS-SSS 的 PASS、MOI 满意度阈值、SCB 绝对分数、SCB 变化评​​分和 MCID（基线/变化评分方法）分别为 77.0、44.6%、92.7、30.6 和 10.6，运动员以高比率达到阈值（分别为 80.0%、80.5%、45.0%、54.0% 和 79.5%）。

结论：

本研究确定了 HOS-SSS 的值，该值可用于定义 FAIS 初次髋关节镜检查后运动员具有临床意义的结果。初次髋关节镜检查后运动员在至少 2 年的随访中，HOS-SSS 的 PASS、MOI 满意度阈值、SCB 绝对评分、SCB 变化评​​分和 MCID 分别为 77.0、44.6%、92.7、30.6 和 10.6 .