The aims of this study were to determine if pre-operative pain characteristics (location of maximum severity of pain, presence of non-groin pain, maximum severity of pain and number of pain locations) affect patient-reported outcome measures in patients undergoing periacetabular osteotomy (PAO) for acetabular dysplasia. We reviewed 52 hips (48 patients) treated with PAO for acetabular dysplasia from February 2017 to July 2020 using modified Harris Hip Score (mHHS), Hip Outcome Score (HOS) and international Hip Outcome Tool (iHOT-12) score, radiographic analysis and pain location/severity questionnaires. Descriptive statistics, analysis of covariance and Spearman partial correlation coefficients were implemented. Twenty-six hips experienced the most severe pre-operative pain in the groin, and 26 hips experienced equal or greater pain in a non-groin location. Outcome scores between these groups were not significantly different (mHHS P = 0.59, HOS P = 0.48, iHOT-12 P = 0.99). Additionally, the presence of pre-operative pain in any non-groin location had no significant relationship with PROM (all P-values ≥0.14). Furthermore, the maximum severity of pre-operative pain and number of pain locations showed no significant relationship with PROM (maximum severity: mHHS P = 0.82, HOS P = 0.99, iHOT-12 P = 0.36; number of pain locations: mHHS P = 0.56, HOS P = 0.10, iHOT-12 P = 0.62). Varying pre-operative pain characteristics do not appear to have any significant impact on outcomes. Therefore, a wide array of patients with acetabular dysplasia might expect similar, favourable outcomes from PAO regardless of pre-operative pain characteristics.

The changes in psychologic measures and symptoms of depression, anxiety, and pain catastrophizing following periacetabular osteotomy (PAO) are not well studied. This study aims to fill this knowledge gap by addressing the question: Do patients with acetabular dysplasia have significant improvement in psychological outcome scores after PAO? We reviewed 52 hips (48 patients) treated with PAO for acetabular dysplasia from February 2017 to July 2020 using Depression, Anxiety, and Stress Scale – 21 (DASS21), Hospital Anxiety and Depression Scale (HADS), Pain Catastrophizing Scale (PCS), radiographic analysis, and pain location/severity questionnaires. Descriptive statistics and a mixed effects model were used to test the difference in patient-reported outcome measures from before and after surgery with adjustment for age, body mass index, follow-up duration, previous hip surgery, and concurrent surgery while also accounting for clustered data. There was a statistically significant difference between preoperative and postoperative outcome scores for all three measures used in this study (DASS21 p = 3.22E-09; HADS p = 2.82E-10, PCS p = 2.12E-09). These results indicate that patients with acetabular dysplasia might expect significant improvement in symptoms of depression, anxiety, and pain catastrophizing following PAO.

Aims This study aims to answer the following questions in patients with hip osteoarthritis (OA) who underwent total hip arthroplasty (THA): are patient-reported outcome measures (PROMs) affected by the location of the maximum severity of pain?; are PROMs affected by the presence of non-groin pain?; are PROMs affected by the severity of pain?; and are PROMs affected by the number of pain locations? Methods We reviewed 336 hips (305 patients) treated with THA for hip OA from December 2016 to November 2019 using pain location/severity questionnaires, modified Harris Hip Score (mHHS), Hip Outcome Score (HOS), international Hip Outcome Tool (iHOT-12) score, and radiological analysis. Descriptive statistics, analysis of covariance (ANCOVA), and Spearman partial correlation coefficients were used. Results There was a significant difference in iHOT-12 scores between groups experiencing the most severe pain in the groin and the trochanter (p = 0.039). Additionally, more favourable mHHS scores were related to the presence of preoperative pain in trochanter (p = 0.049), lower back (p = 0.056), lateral thigh (p = 0.034), and posterior thigh (p = 0.005). Finally, the maximum severity of preoperative pain and number of pain locations had no significant relationship with PROMs (maximum severity: HHS: p = 0.928, HOS: p = 0.163, iHOT-12 p = 0.233; number of pain locations: HHS: p = 0.211; HOS: p = 0.801; iHOT-12: p = 0.112). Conclusion Although there was a significant difference in iHOT-12 scores between patients with the most severe pain in the groin or trochanter, and the presence of pain in the trochanter, lower back, lateral thigh, or posterior thigh was related to higher mHHS scores, the majority of preoperative pain characteristics did not have a significant impact on outcomes. Therefore, a broad array of patients with hip OA might expect similar, favourable outcomes from THA notwithstanding preoperative pain characteristics. Cite this article: Bone Jt Open 2022;3(4):332–339.

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