PMID- 30396799
OWN - NLM
STAT- MEDLINE
DCOM- 20191008
LR  - 20220408
IS  - 1526-3231 (Electronic)
IS  - 0749-8063 (Linking)
VI  - 34
IP  - 12
DP  - 2018 Dec
TI  - The Influence of Pain in Other Major Joints and the Spine on 2-Year Outcomes 
      After Hip Arthroscopy.
PG  - 3196-3201
LID - S0749-8063(18)30588-7 [pii]
LID - 10.1016/j.arthro.2018.07.020 [doi]
AB  - PURPOSE: To determine whether patients who have pain in other major joints or the 
      spine have poorer postsurgical outcomes than patients without comorbid 
      orthopaedic pain. METHODS: We performed a review of a prospectively maintained 
      institutional surgical registry of patients who underwent hip arthroscopy between 
      January 1, 2012, and July 16, 2015, by a single surgeon, with a minimum of 
      2 years of postoperative follow-up. A musculoskeletal morbidity (MSM) score was 
      assigned to each patient preoperatively based on the presence of pain in other 
      joints and the spine (grade 1, hip only; grade 2, hip and other major joints 
      without spine; grade 3, hip with spine; and grade 4, hip and other major joints 
      with spine). Preoperatively and at 2 years postoperatively, functional outcomes 
      were measured using the Hip Outcome Score-Activities of Daily Living (HOS-ADL), 
      and the percentages of patients achieving a minimal clinically important 
      difference (MCID) and patient-acceptable symptom state (PASS) were calculated. 
      RESULTS: In total, 821 patients were identified, of whom 700 (85.3%) completed 
      2-year follow-up. Preoperatively, MSM grade 1 patients had a higher HOS-ADL than 
      grade 2 patients (P = .02), but there was no difference between grade 1 and grade 
      3 patients (P = .63) or between grade 1 and grade 4 patients (P = .14). Likewise, 
      there was no difference in the preoperative HOS-ADL among grades 2, 3, and 4. 
      Patients with MSM grades 1 and 2 were younger than those with grades 3 and 4. At 
      2 years postoperatively, MSM grade 1 patients had higher HOS-ADL values than 
      grade 3 (P = .01) and grade 4 (P = .02) but not grade 2 (P = .07) patients. 
      Overall, 84% of patients showed an MCID and 72% of patients achieved a PASS with 
      regard to the HOS-ADL. There were no statistically significant differences among 
      MSM grades in terms of the MCID or PASS. CONCLUSIONS: Overall, 84% of patients 
      improved with hip arthroscopy by MCID criteria for the HOS-ADL. Patients with no 
      pain in other joints (MSM grade 1) had better 2-year postoperative HOS-ADL values 
      after hip arthroscopy than patients with spine pain (grades 3 and 4). However, 
      there were no significant differences in the MCID or PASS among patients with 
      regard to MSM grade. A total of 40.5% of patients who underwent hip arthroscopy 
      had pain in another joint. A limitation, however, is that there is potential for 
      a type II error, in that there may not have been a sufficient number of patients 
      studied to detect a significant difference in outcome among patients with 
      different grades of musculoskeletal comorbidity. LEVEL OF EVIDENCE: Level IV, 
      therapeutic case series.
CI  - Copyright (c) 2018 Arthroscopy Association of North America. Published by Elsevier 
      Inc. All rights reserved.
FAU - Leong, Natalie L
AU  - Leong NL
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, U.S.A.. Electronic address: Natalie_L_Leong@rush.edu.
FAU - Clapp, Ian M
AU  - Clapp IM
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, U.S.A.
FAU - Neal, William H
AU  - Neal WH
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, U.S.A.
FAU - Beck, Edward
AU  - Beck E
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, U.S.A.
FAU - Bush-Joseph, Charles A
AU  - Bush-Joseph CA
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, U.S.A.
FAU - Nho, Shane J
AU  - Nho SJ
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, 
      Illinois, U.S.A.
LA  - eng
PT  - Journal Article
DEP - 20181102
PL  - United States
TA  - Arthroscopy
JT  - Arthroscopy : the journal of arthroscopic & related surgery : official 
      publication of the Arthroscopy Association of North America and the International 
      Arthroscopy Association
JID - 8506498
SB  - IM
CIN - Arthroscopy. 2018 Dec;34(12):3202-3203. PMID: 30509430
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Arthralgia/*physiopathology
MH  - *Arthroscopy
MH  - Back Pain/*physiopathology
MH  - Child
MH  - *Disability Evaluation
MH  - Female
MH  - Follow-Up Studies
MH  - Hip Joint/physiopathology/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Registries
MH  - Young Adult
EDAT- 2018/11/07 06:00
MHDA- 2019/10/09 06:00
CRDT- 2018/11/07 06:00
PHST- 2018/01/02 00:00 [received]
PHST- 2018/06/29 00:00 [revised]
PHST- 2018/07/05 00:00 [accepted]
PHST- 2018/11/07 06:00 [pubmed]
PHST- 2019/10/09 06:00 [medline]
PHST- 2018/11/07 06:00 [entrez]
AID - S0749-8063(18)30588-7 [pii]
AID - 10.1016/j.arthro.2018.07.020 [doi]
PST - ppublish
SO  - Arthroscopy. 2018 Dec;34(12):3196-3201. doi: 10.1016/j.arthro.2018.07.020. Epub 
      2018 Nov 2.