Introduction

Studies have demonstrated a negative relationship between the length of time with symptoms and patient-reported outcome measures in primary hip arthroscopy. Our aim was to expand the generalizability of this finding with a multi-center cohort.

Methods

A multi-center hip arthroscopy registry was queried for patients undergoing primary hip arthroscopy from 2014 to 2017. Patients were stratified according to whether pre-operative symptom duration exceeded two years or did not exceed two years. A Wilcoxon rank sum test was performed for differences in two year post-operative outcome scores. Logistic regression models analyzed the influence of symptom duration on achieving clinically meaningful thresholds (minimum clinically important difference, patient-acceptable symptom state, substantial clinical benefit) when controlling for baseline scores, age, BMI, and sex.

Results

Seven hundred forty-four patients met the inclusion criteria, from which 620 had complete outcomes information. The mean ± SD 2-year iHOT-12 scores of patients with symptom duration greater than two years (69 ± 26) were significantly lower than patients with symptom duration less than two years (77 ± 23) (Dunn test, p < 0.001). Chronic duration of pain was a negative predictor of achieving iHOT-12 MCID (0.47 [0.31–0.72]), PASS (0.53 [0.37–0.76]), and SCB (0.67 [0.47–0.94]).

Conclusion

When controlling for differences in baseline demographic factors and pre-operative iHOT-12 scores, patients with chronic pain report poorer functional outcomes at mid-term follow-up. These results suggest that chronic pain predicts inferior outcomes from primary hip arthroscopy and that surgical intervention at earlier time points may be beneficial in achieving better outcomes.

中文翻译：

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症状持续时间预示着髋关节镜检查后较差的中期结果

介绍

研究表明，在初次髋关节镜检查中，出现症状的时间长度与患者报告的结果测量之间存在负相关关系。我们的目标是通过多中心队列扩大这一发现的普遍性。

方法

对 2014 年至 2017 年接受初次髋关节镜检查的患者查询多中心髋关节镜登记。根据术前症状持续时间是否超过两年或不超过两年对患者进行分层。对术后两年结果评分的差异进行了 Wilcoxon 秩和检验。在控制基线评分、年龄、BMI 和性别时，逻辑回归模型分析了症状持续时间对达到临床有意义阈值（最小临床重要差异、患者可接受的症状状态、实质性临床益处）的影响。

结果

744 名患者符合纳入标准，其中 620 名患者具有完整的结局信息。症状持续时间超过两年的患者 (69 ± 26) 的平均 ± SD 2 年 iHOT-12 评分显着低于症状持续时间小于两年的患者 (77 ± 23)（Dunn 检验，p  < 0.001） . 慢性疼痛持续时间是实现 iHOT-12 MCID (0.47 [0.31–0.72])、PASS (0.53 [0.37–0.76]) 和 SCB (0.67 [0.47–0.94]) 的负面预测因子。

结论

在控制基线人口统计学因素和术前 iHOT-12 评分的差异时，慢性疼痛患者在中期随访时报告的功能结果较差。这些结果表明，慢性疼痛预示着初次髋关节镜检查的结果较差，而在早期时间点进行手术干预可能有利于获得更好的结果。