PMID- 30067064
OWN - NLM
STAT- MEDLINE
DCOM- 20191021
LR  - 20220409
IS  - 1552-3365 (Electronic)
IS  - 0363-5465 (Linking)
VI  - 46
IP  - 11
DP  - 2018 Sep
TI  - Time Required to Achieve Minimal Clinically Important Difference and Substantial 
      Clinical Benefit After Arthroscopic Treatment of Femoroacetabular Impingement.
PG  - 2601-2606
LID - 10.1177/0363546518786480 [doi]
AB  - BACKGROUND: Minimal clinically important difference (MCID) defines the minimum 
      degree of quantifiable outcome improvement that a patient perceives as the result 
      of an intervention or in the process of healing. Substantial clinical benefit 
      (SCB) defines the amount of quantifiable outcome improvement that is needed for a 
      patient to feel substantially better. Little is known about when clinically 
      significant outcome improvement is achieved. PURPOSE: To investigate the 
      time-dependent nature of MCID and SCB after hip arthroscopy for femoroacetabular 
      impingement (FAI). STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: An 
      institutional hip preservation registry was queried. The modified Harris Hip 
      Score, Hip Outcome Score, and 33-item International Hip Outcome Tool (iHOT-33) 
      were administered to patients undergoing hip arthroscopy for FAI. Follow-up times 
      for outcome measures were classified into 3 periods: 5 to 11 months (6 months), 
      12 to 23 months (1 year), and 24 to 35 months (2 years). Cumulative probabilities 
      for achieving MCID and SCB were calculated with Kaplan-Meier survival curve 
      analysis and interval censoring. A Weibull parametric regression analysis 
      evaluated the odds of achieving earlier MCID. RESULTS: A total of 719 patients 
      undergoing primary hip arthroscopy were included. The mean +/- SD age was 32.5 +/- 
      10.5 years, and the majority were female (n = 380, 52.9%). Across all 4 outcome 
      instruments, patients had the highest probability for achieving MCID and SCB by 
      the 6-month postoperative period. The iHOT-33 demonstrated the highest 
      probability for capturing MCID and SCB improvement at each of the 3 periods, with 
      76.0%, 84.8%, and 93.6% achieving MCID by 6 months, 1 year, and 2 years, 
      respectively. Similarly, the probabilities of achieving SCB on the iHOT-33 were 
      as follows: 57.1%, 68.0%, and 71.7%. A similar trend was demonstrated across 
      other outcome tools. Older male patients and those with Outerbridge 
      classification 1 to 4 (vs grade 0) had a significantly increased risk for taking 
      a longer time to achieve MCID and SCB. Additionally, patients with higher 
      preoperative outcome scores took a longer time to achieve MCID and SCB. 
      CONCLUSION: At least half of patients treated with hip arthroscopy for FAI 
      achieve MCID and SCB within the first 6 months after the procedure. However, 
      clinically significant outcome improvement continues to be attained until 2 years 
      postoperatively. Female patients, younger individuals, and those without chondral 
      defects achieve faster clinical outcome improvement. These findings can be 
      helpful for establishing shared decision-making aids and follow-up guidelines for 
      arthroscopic treatment of FAI.
FAU - Nwachukwu, Benedict U
AU  - Nwachukwu BU
AD  - Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New 
      York, USA.
FAU - Chang, Brenda
AU  - Chang B
AD  - Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New 
      York, USA.
FAU - Adjei, Joshua
AU  - Adjei J
AD  - Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New 
      York, USA.
FAU - Schairer, William W
AU  - Schairer WW
AD  - Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New 
      York, USA.
FAU - Ranawat, Anil S
AU  - Ranawat AS
AD  - Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New 
      York, USA.
FAU - Kelly, Bryan T
AU  - Kelly BT
AD  - Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New 
      York, USA.
FAU - Nawabi, Danyal H
AU  - Nawabi DH
AD  - Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New 
      York, USA.
LA  - eng
PT  - Journal Article
DEP - 20180801
PL  - United States
TA  - Am J Sports Med
JT  - The American journal of sports medicine
JID - 7609541
SB  - IM
MH  - Activities of Daily Living
MH  - Adult
MH  - Arthroscopy/*statistics & numerical data
MH  - Cohort Studies
MH  - Female
MH  - Femoracetabular Impingement/*surgery
MH  - Humans
MH  - Male
MH  - *Minimal Clinically Important Difference
MH  - Postoperative Period
MH  - *Registries
MH  - Treatment Outcome
MH  - Young Adult
OTO - NOTNLM
OT  - epidemiology
OT  - femoroacetabular impingement
OT  - hip arthroscopy
OT  - minimal clinically important difference
OT  - outcome
OT  - quality of life
OT  - substantial clinical benefit
EDAT- 2018/08/02 06:00
MHDA- 2019/10/23 06:00
CRDT- 2018/08/02 06:00
PHST- 2018/08/02 06:00 [pubmed]
PHST- 2019/10/23 06:00 [medline]
PHST- 2018/08/02 06:00 [entrez]
AID - 10.1177/0363546518786480 [doi]
PST - ppublish
SO  - Am J Sports Med. 2018 Sep;46(11):2601-2606. doi: 10.1177/0363546518786480. Epub 
      2018 Aug 1.