■与疼痛持续时间较短的患者相比,股骨髋臼撞击综合征(FAIS)的髋关节镜手术前髋关节疼痛≥2年的患者短期和中期预后较差。尽管在该人群中评估达到临床显著结局(CSO)的时间的文献有限.
■比较有和没有长期髋关节疼痛的患者在髋关节关节镜手术后达到CSO的时间,并确定延迟达到CSO的独立预测因素。
■队列研究;证据水平,3.
■在2012年1月至2019年7月期间接受FAIS初次髋关节镜手术的患者,为期6个月,1年,并确定了2年髋关节结果评分-日常生活活动(HOS-ADL)和髋关节结果评分-运动子量表(HOS-SS)评分。长期髋部疼痛(术前持续时间≥2年)的患者倾向评分与对照组(术前持续时间<2年)相匹配,控制年龄,性别,体重指数(BMI)。使用Kaplan-Meier生存分析比较两组之间达到最小临床重要差异的时间和患者可接受的症状状态。考虑年龄的多变量Cox回归,性别,BMI,疼痛持续时间,活动水平,软骨状态被用来确定公民社会组织延迟实现的独立预测因素。
■总共179名髋部长期疼痛患者与179名对照患者(平均疼痛持续时间,60.5±51.2vs9.7±5.1个月,分别;P<.001)相似年龄,性别,和BMI(P≥.488)具有相似的基线HOS-ADL和HOS-SS评分(P≥.971)。在Kaplan-Meier分析中,对于HOS-ADL和HOS-SS,长时间的髋部疼痛组显示出最小临床重要差异和患者可接受的症状状态的延迟实现(P≤.020)。关于多元Cox回归,髋部疼痛持续时间≥2年被证明是CSO延迟成就的独立预测因素,风险比范围为1.32至1.65(P≤0.029)。公民社会组织延迟实现的其他独立预测因素包括年龄增加,不断增加的BMI,女性性别,自我认可的每周参加体育活动,和高级软骨缺陷(危险比范围,1.01-4.89;P≤.045)。
■这项研究的结果表明,术前髋部疼痛持续时间≥2年是FAIS初次髋关节镜手术后延迟实现CSO的独立预测因素。
UNASSIGNED: Patients with hip pain ≥2 years before hip arthroscopic surgery for femoroacetabular impingement syndrome (FAIS) have been shown to achieve inferior short-term and midterm outcomes compared with patients with a shorter pain duration, although there is limited literature that has evaluated the time to achieve clinically significant outcomes (CSOs) in this population.
UNASSIGNED: To compare the time to achieve CSOs after hip arthroscopic surgery for FAIS in patients with and without prolonged hip pain and to identify independent predictors of the delayed achievement of CSOs.
UNASSIGNED: Cohort study; Level of evidence, 3.
UNASSIGNED: Patients who underwent primary hip arthroscopic surgery for FAIS between January 2012 and July 2019 with 6-month, 1-year, and 2-year Hip Outcome Score-Activities of Daily Living (HOS-ADL) and Hip Outcome Score-Sports Subscale (HOS-SS) scores were identified. Patients with prolonged hip pain (preoperative duration ≥2 years) were propensity score matched to a control group (preoperative duration <2 years), controlling for age, sex, and body mass index (BMI). The times to achieve the minimal clinically important difference and Patient Acceptable Symptom State were compared between groups using Kaplan-Meier survival analysis. Multivariate Cox regression considering age, sex, BMI, pain duration, activity level, and chondral status was used to identify independent predictors of the delayed achievement of CSOs.
UNASSIGNED: A total of 179 patients with prolonged hip pain were matched to 179 control patients (mean pain duration, 60.5 ± 51.2 vs 9.7 ± 5.1 months, respectively; P < .001) of a similar age, sex, and BMI (P≥ .488) with similar baseline HOS-ADL and HOS-SS scores (P≥ .971). The prolonged hip pain group showed delayed achievement of the minimal clinically important difference and Patient Acceptable Symptom State for both the HOS-ADL and HOS-SS on Kaplan-Meier analysis (P≤ .020). On multivariate Cox regression, hip pain duration ≥2 years was shown to be an independent predictor of the delayed achievement of CSOs, with hazard ratios ranging from 1.32 to 1.65 (P≤ .029). Additional independent predictors of the delayed achievement of CSOs included increasing age, increasing BMI, female sex, self-endorsed weekly participation in physical activity, and high-grade chondral defects (hazard ratio range, 1.01-4.89; P≤ .045).
UNASSIGNED: Findings from this study demonstrate that preoperative hip pain duration ≥2 years was an independent predictor of the delayed achievement of CSOs after primary hip arthroscopic surgery for FAIS.