PMID- 35964857 OWN - NLM STAT- MEDLINE DCOM- 20230110 LR - 20230201 IS - 1532-8406 (Electronic) IS - 0883-5403 (Linking) VI - 38 IP - 2 DP - 2023 Feb TI - Should We Aim to Help Patients "Feel Better" or "Feel Good" After Total Hip Arthroplasty? Determining Factors Affecting the Achievement of the Minimal Clinically Important Difference and Patient Acceptable Symptom State. PG - 293-299 LID - S0883-5403(22)00754-9 [pii] LID - 10.1016/j.arth.2022.08.014 [doi] AB - BACKGROUND: Recent attempts have been made to use preoperative patient-reported outcome measure (PROM) thresholds as prior authorization criteria based on the assumption that patients who have higher baseline scores are less likely to achieve the minimal clinically important difference (MCID). This study aimed to identify factors affecting the achievement of MCID and patient acceptable symptom state (PASS) after total hip arthroplasty (THA), and to determine the overlap between the two outcomes. METHODS: We identified 3,581 primary, unilateral THAs performed at a single practice in 2015-2019. PROMs including Hip Disability and Osteoarthritis Outcome Score for Joint Replacement (HOOS-JR) and 12-item Short Form Health Survey were collected preoperatively and 1-year postoperatively. The likelihood of attaining PASS according to attainment of MCID was assessed. Multivariable regression was used to identify independent predictors of MCID and PASS. RESULTS: In total, 79.8% achieved MCID and 73.6% achieved PASS for HOOS-JR. Approximately 1 in 7 patients who achieved MCID did not eventually achieve PASS. Worse preoperative HOOS-JR (odd ratio 0.933) was associated with MCID attainment. Better preoperative HOOS-JR (odd ratio 1.015) was associated with PASS attainment. Men, lower body mass index, better American Society of Anesthesiologists score, and better preoperative 12-item Short Form Health Survey mental score were predictors of MCID and PASS. Age, race, ethnicity, Charlson Comorbidity Index, and smoking status were not significant predictors. CONCLUSION: Preoperative PROMs were associated with achieving MCID and PASS after THA, albeit in opposite directions. Clinicians should strive to help patients "feel better" and "feel good" after surgery. Preoperative PROMs should not solely be used to prioritize access to care. CI - Copyright (c) 2022 Elsevier Inc. All rights reserved. FAU - Goh, Graham S AU - Goh GS AD - Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, Pennsylvania. FAU - Tarabichi, Saad AU - Tarabichi S AD - Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, Pennsylvania. FAU - Baker, Colin M AU - Baker CM AD - Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, Pennsylvania. FAU - Qadiri, Qudratullah S AU - Qadiri QS AD - Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, Pennsylvania. FAU - Austin, Matthew S AU - Austin MS AD - Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, Pennsylvania. LA - eng PT - Journal Article DEP - 20220812 PL - United States TA - J Arthroplasty JT - The Journal of arthroplasty JID - 8703515 SB - IM MH - Male MH - Humans MH - *Arthroplasty, Replacement, Hip MH - Minimal Clinically Important Difference MH - Treatment Outcome MH - Patient Reported Outcome Measures OTO - NOTNLM OT - acceptable symptom state OT - clinically important difference OT - hip arthroplasty OT - patient-reported outcomes OT - prior authorization OT - value-based care EDAT- 2022/08/15 06:00 MHDA- 2023/01/11 06:00 CRDT- 2022/08/14 19:26 PHST- 2022/04/25 00:00 [received] PHST- 2022/08/04 00:00 [revised] PHST- 2022/08/07 00:00 [accepted] PHST- 2022/08/15 06:00 [pubmed] PHST- 2023/01/11 06:00 [medline] PHST- 2022/08/14 19:26 [entrez] AID - S0883-5403(22)00754-9 [pii] AID - 10.1016/j.arth.2022.08.014 [doi] PST - ppublish SO - J Arthroplasty. 2023 Feb;38(2):293-299. doi: 10.1016/j.arth.2022.08.014. Epub 2022 Aug 12.