PMID- 32924530 OWN - NLM STAT- MEDLINE DCOM- 20210114 LR - 20210114 IS - 1552-3365 (Electronic) IS - 0363-5465 (Linking) VI - 48 IP - 12 DP - 2020 Oct TI - Radiographic Indices Are Not Predictive of Clinical Outcomes Among 1735 Patients Indicated for Hip Arthroscopic Surgery: A Machine Learning Analysis. PG - 2910-2918 LID - 10.1177/0363546520950743 [doi] AB - BACKGROUND: The relationship between the preoperative radiographic indices for femoroacetabular impingement syndrome (FAIS) and postoperative patient-reported outcome measure (PROM) scores continues to be under investigation, with inconsistent findings reported. PURPOSE: To apply a machine learning model to determine which preoperative radiographic indices, if any, among patients indicated for the arthroscopic correction of FAIS predict whether a patient will achieve the minimal clinically important difference (MCID) for 1- and 2-year PROM scores. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: A total of 1735 consecutive patients undergoing primary hip arthroscopic surgery for FAIS were included from an institutional hip preservation registry. Patients underwent preoperative computed tomography of the hip, from which the following radiographic indices were calculated by a musculoskeletal radiologist: alpha angle, beta angle, sagittal center-edge angle, coronal center-edge angle, neck shaft angle, acetabular version angle, and femoral version angle. PROM scores were collected preoperatively, at 1 year postoperatively, and at 2 years postoperatively for the modified Harris Hip Score (mHHS), the Hip Outcome Score (HOS)-Activities of Daily Living (HOS-ADL) and -Sport Specific (HOS-SS), and the International Hip Outcome Tool (iHOT-33). Random forest models were created for each PROM at 1 and 2 years' follow-up, with each PROM's MCID used to establish clinical meaningfulness. Data inputted into the models included ethnicity, laterality, sex, age, body mass index, and radiographic indices. Comprehensive and separate models were built specifically to assess the association of the alpha angle, femoral version angle, coronal center-edge angle, McKibbin index, and hip impingement index with respect to each PROM. RESULTS: As evidenced by poor area under the curves and P values >.05 for each model created, no combination of radiographic indices or isolated index (alpha angle, coronal center-edge angle, femoral version angle, McKibbin index, hip impingement index) was a significant predictor of a clinically meaningful improvement in scores on the mHHS, HOS-ADL, HOS-SS, or iHOT-33. The mean difference between 1- and 2-year PROM scores compared with preoperative values exceeded the respective MCIDs for the cohort. CONCLUSION: In patients appropriately indicated for FAIS corrective surgery, clinical improvements can be achieved, regardless of preoperative radiographic indices, such as the femoral version angle, coronal center-edge angle, and alpha angle. No specific radiographic parameter or combination of indices was found to be predictive of reaching the MCID for any of the 4 studied hip-specific PROMs at either 1 or 2 years' follow-up. FAU - Ramkumar, Prem N AU - Ramkumar PN AD - Orthopaedic Machine Learning Lab, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Karnuta, Jaret M AU - Karnuta JM AD - Orthopaedic Machine Learning Lab, Cleveland Clinic, Cleveland, Ohio, USA. FAU - Haeberle, Heather S AU - Haeberle HS AD - Orthopaedic Machine Learning Lab, Cleveland Clinic, Cleveland, Ohio, USA. AD - Sports Medicine - Hip Preservation Service, Hospital for Special Surgery, New York, New York, USA. FAU - Sullivan, Spencer W AU - Sullivan SW AD - Sports Medicine - Hip Preservation Service, Hospital for Special Surgery, New York, New York, USA. FAU - Nawabi, Danyal H AU - Nawabi DH AD - Sports Medicine - Hip Preservation Service, Hospital for Special Surgery, New York, New York, USA. FAU - Ranawat, Anil S AU - Ranawat AS AD - Sports Medicine - Hip Preservation Service, Hospital for Special Surgery, New York, New York, USA. FAU - Kelly, Bryan T AU - Kelly BT AD - Sports Medicine - Hip Preservation Service, Hospital for Special Surgery, New York, New York, USA. FAU - Nwachukwu, Benedict U AU - Nwachukwu BU AD - Sports Medicine - Hip Preservation Service, Hospital for Special Surgery, New York, New York, USA. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20200914 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 - *Arthroscopy MH - Cohort Studies MH - *Femoracetabular Impingement/diagnostic imaging/surgery MH - Hip Joint/*diagnostic imaging/surgery MH - Humans MH - *Machine Learning MH - Minimal Clinically Important Difference MH - Patient Reported Outcome Measures MH - Treatment Outcome OTO - NOTNLM OT - femoroacetabular impingement OT - hip arthroscopic surgery OT - machine learning OT - outcomes OT - radiographic indices EDAT- 2020/09/15 06:00 MHDA- 2021/01/15 06:00 CRDT- 2020/09/14 15:37 PHST- 2020/09/15 06:00 [pubmed] PHST- 2021/01/15 06:00 [medline] PHST- 2020/09/14 15:37 [entrez] AID - 10.1177/0363546520950743 [doi] PST - ppublish SO - Am J Sports Med. 2020 Oct;48(12):2910-2918. doi: 10.1177/0363546520950743. Epub 2020 Sep 14.