■在股骨髋臼撞击(FAI)的患者中,心理健康与症状严重程度和术后结局有关.然而,关于基线心理健康和髋关节病理对髋关节镜检查后患者报告结局的独立影响的数据有限.
■为了评估心理健康和结构性髋关节病理与疼痛之间的关系,髋关节功能,和生活质量(QOL)。
■队列研究;证据水平,3.
■回顾性回顾了一位外科医生髋部结局登记的患者记录。使用患者报告的结果测量信息系统焦虑和抑郁评分评估心理健康。疼痛用日常生活活动的单一评估数字评估评分(SANE-ADL)进行评估,使用12项国际髋关节结果工具(iHOT-12)评估髋关节相关生活质量。用髋关节结果评分(HOS)运动特异性(SS)和ADL量表评估髋关节功能。使用单独的混合模型来预测疼痛,QOL,和髋关节功能,包括髋关节病理学测量(唇撕裂的大小,软骨损伤等级,术前α角),焦虑,抑郁症,时间作为固定效应,个体作为随机效应。
■本研究共纳入312例患者。术前α角,术中软骨损伤程度,唇撕裂的大小与疼痛或生活质量无关(P>0.05)。然而,较高的焦虑和抑郁水平与较低的SANE-ADL评分(估计±SE)显着相关(焦虑:-0.59±0.07,P<.0001;抑郁:-0.64±0.08,P<.0001),iHOT-12评分(焦虑:-0.72±0.07,P<.0001;抑郁:-0.72±0.08,P<.0001),HOS-SS评分(焦虑:-0.68±0.09,P<.0001;抑郁:-0.57±0.10,P<.0001),和HOS-ADL评分(焦虑:-0.43±0.05,P<.0001;抑郁:-0.43±0.06,P<.0001)。
■患者疼痛评分有相似的改善,QOL,髋关节镜检查FAI后的髋关节功能与髋关节病理程度无关。此外,术前焦虑和抑郁症状与更大的疼痛有关,QOL下降,术前和术后髋关节功能更差,与髋关节病理程度无关。这表明直接解决焦虑和抑郁症状的努力可能会改善髋关节镜检查后的结果。
UNASSIGNED: In patients with femoroacetabular impingement (FAI), mental health has been implicated in both symptom severity and postoperative outcomes. However, there are limited data regarding the independent influences of baseline mental health and hip pathology on patient-reported outcomes over time after hip arthroscopy.
UNASSIGNED: To evaluate the association between mental health and structural hip pathology with pain, hip function, and quality of life (QOL).
UNASSIGNED: Cohort study; Level of evidence, 3.
UNASSIGNED: Patient records from a single surgeon\'s hip outcomes registry were retrospectively reviewed. Mental health was evaluated using the Patient-Reported Outcomes Measurement Information System Anxiety and Depression scores. Pain was evaluated with the Single Assessment Numeric Evaluation score for Activities of Daily Living (SANE-ADL), while hip-related QOL was evaluated with the 12-item International Hip Outcome Tool (iHOT-12). Hip function was assessed with the Hip Outcome Score (HOS) Sport-Specific (SS) and ADL subscales. Separate mixed models were used to predict pain, QOL, and hip function, including hip pathology measures (size of labral tear, grade of chondral damage, preoperative alpha angle), anxiety, depression, and time as fixed effects and individuals as a random effect.
UNASSIGNED: A total of 312 patients were included in this study. The preoperative alpha angle, degree of intraoperative cartilage damage, and size of the labral tear were not associated with pain or QOL (P > .05 for all). However, higher levels of anxiety and depression were significantly associated with lower SANE-ADL scores (estimate ± SE) (anxiety: -0.59 ± 0.07, P < .0001; depression: -0.64 ± 0.08, P < .0001), iHOT-12 scores (anxiety: -0.72 ± 0.07, P < .0001; depression: -0.72 ± 0.08, P < .0001), HOS-SS scores (anxiety: -0.68 ± 0.09, P < .0001; depression: -0.57 ± 0.10, P < .0001), and HOS-ADL scores (anxiety: -0.43 ± 0.05, P < .0001; depression: -0.43 ± 0.06, P < .0001).
UNASSIGNED: Patients had similar improvements in pain scores, QOL, and hip function after hip arthroscopy for FAI irrespective of their degree of hip pathology. Additionally, preoperative symptoms of anxiety and depression symptoms were associated with greater pain, decreased QOL, and worse hip function both pre- and postoperatively, independent of the degree of hip pathology. This suggests that efforts to directly address symptoms of anxiety and depression may improve outcomes after hip arthroscopy.