PMID- 31603720 OWN - NLM STAT- MEDLINE DCOM- 20200521 LR - 20200521 IS - 1552-3365 (Electronic) IS - 0363-5465 (Linking) VI - 47 IP - 13 DP - 2019 Nov TI - How Can We Define Clinically Important Improvement in Pain Scores After Hip Arthroscopy for Femoroacetabular Impingement Syndrome? Minimum 2-Year Follow-up Study. PG - 3133-3140 LID - 10.1177/0363546519877861 [doi] AB - BACKGROUND: Patient postoperative pain is being increasingly reported in the field of hip preservation surgery. The visual analog scale (VAS) for pain is one of the most commonly utilized measures for perioperative pain assessment. Currently, there is limited understanding of clinically significant improvement in VAS pain. PURPOSE: (1) To define the substantial clinical benefit (SCB), patient acceptable symptomatic state (PASS), and minimal clinically important difference (MCID) for the VAS pain score in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome after 2 years from surgery and (2) to identify preoperative predictors of achieving each outcome endpoint. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Data from consecutive patients who underwent primary hip arthroscopy between November 2014 and March 2017 were collected and analyzed. Baseline data and postoperative patient-reported outcome scores were recorded at 2 years postoperatively. To quantify clinical significance of outcome achievement for the VAS pain score, the MCID, PASS, and SCB were calculated. RESULTS: A total of 976 patients were included in the final analysis. The VAS pain score threshold for achieving the MCID was defined as a decrease of 14.8; the PASS was defined as achieving a 2-year postoperative score of 21.6 points; and the SCB was defined as a decrease of 25.5 or a score of 15.4 points at 2 years. The rates of achieving the MCID, PASS, and SCB were 97.6%, 66.4%, and 71.2%, respectively. Regression analysis demonstrated that sports involvement, low body mass index, smaller preoperative alpha angle, and absence of articular damage and chondromalacia were predictive of achieving the PASS (all P < .05). Preoperative predictors for achieving the SCB included being male, no smoking history, smaller alpha angle, higher modified Harris Hip Score, and lower VAS pain score (all P < .05). CONCLUSION: This study identified scores for VAS pain that can be used to define clinically significant outcome after arthroscopic treatment of femoroacetabular impingement syndrome. Specifically, a decrease in pain score of 14.8 was a clinically important improvement in VAS pain, while an absolute score <15.4 or a change of 25.5 represented the upper threshold of VAS pain improvement. Additionally, there were both modifiable and nonmodifiable factors that predicted achieving clinically significant levels of postoperative pain improvement. FAU - Beck, Edward C AU - Beck EC AD - Department of Orthopedic Surgery, Wake Forest Baptist Health, Winston-Salem, North Carolina, USA. FAU - Nwachukwu, Benedict U AU - Nwachukwu BU AD - Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA. FAU - Kunze, Kyle N AU - Kunze KN AD - Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA. FAU - Chahla, Jorge AU - Chahla J AD - Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA. FAU - Nho, Shane J AU - Nho SJ AD - Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20191011 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/*rehabilitation MH - Body Mass Index MH - Cartilage Diseases MH - Female MH - Femoracetabular Impingement/*surgery MH - Follow-Up Studies MH - Humans MH - Male MH - Middle Aged MH - *Minimal Clinically Important Difference MH - Pain Measurement MH - Pain, Postoperative MH - Patient Reported Outcome Measures MH - Postoperative Period MH - Sports MH - Treatment Outcome MH - *Visual Analog Scale MH - Young Adult OTO - NOTNLM OT - MCID OT - PASS OT - SCB OT - VAS pain OT - femoroacetabular impingement syndrome EDAT- 2019/10/12 06:00 MHDA- 2020/05/22 06:00 CRDT- 2019/10/12 06:00 PHST- 2019/10/12 06:00 [pubmed] PHST- 2020/05/22 06:00 [medline] PHST- 2019/10/12 06:00 [entrez] AID - 10.1177/0363546519877861 [doi] PST - ppublish SO - Am J Sports Med. 2019 Nov;47(13):3133-3140. doi: 10.1177/0363546519877861. Epub 2019 Oct 11.