Predictors of Clinical Outcomes After Hip Arthroscopy A Prospective Analysis of 1038 Patients With 2-Year Follow-up
Predictors of Clinical Outcomes After Hip Arthroscopy A Prospective Analysis of 1038 Patients With 2-Year Follow-up
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DOI：
10.1177/0363546518763362
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发表时间：
2018-05-01
影响因子：
4.8
通讯作者：
Lodhia, Parth
中科院分区：
文献类型：
--
作者：
Domb, Benjamin G.;Martin, Timothy J.;Lodhia, Parth
背景：随着髋关节镜手术的普及和数量的增加，需要更多关于手术适应症和临床结果预测因素的信息。目的：在一项前瞻性研究中评估髋关节镜的临床结果，并分析队列以确定预测改善的因素。研究设计：病例对照研究；证据水平，3。方法：对2008年2月至2012年6月期间接受髋关节镜检查的所有患者进行前瞻性数据收集。我们纳入了所有接受髋关节镜检查的患者，这些患者同意参与并在至少2年的随访中完成了4项患者报告结果（PRO）工具：改良Harris髋关节评分（mHHS）、非关节炎髋关节评分（NAHS）、髋关节结果评分-日常生活活动（HOS-ADL）和髋关节结果评分-运动特异性亚量表。NAHS被选为我们的主要预后工具。所有既往有髋关节疾病的患者均被排除在外。我们用双变量和多变量分析比较了34个术前和术中变量。结果：该队列包括1038例患者，平均随访30.1个月（范围24.0-61.2个月）。平均年龄36.4岁（范围13.2 ~ 76.4岁）。与术前评分相比，术后2年所有PRO评分均有显著改善（P < 0.001）。双因素分析确定了15个变量（7个分类变量和8个连续变量），多因素分析确定了10个预测术后2年NAHS的变量。在双变量和多变量分析中，术前NAHS、术前HOS-ADL、术前mHHS、年龄、症状持续时间、体重指数（BMI）和髋关节翻修镜检查被确定为预测因素。术前NAHS的预测价值在BMI较高的患者中更为突出。结论：本研究报告了迄今为止文献中最大的髋关节镜手术队列的良好临床结果，随访至少2年。在双变量和多变量分析中确定的预测因素包括术前NAHS、HOS-ADL和mHHS；年龄;症状持续时间；体重指数;还有髋关节镜检查。这些预测因素可能有助于临床医生确定髋关节镜手术的预后和手术指征。
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.