Patient-Reported Outcomes of Periacetabular Osteotomy from the Prospective ANCHOR Cohort Study

Clohisy, John C.; Ackerman, Jeffrey M.; Baca, Geneva; Baty, Jack; Beaulé, Paul E.; Kim, Young Jo; Millis, Michael B.; Podeszwa, David A.; Schoenecker, Perry L.; Sierra, Rafael J.; Sink, Ernest L.; Sucato, Daniel J.; Trousdale, Robert T.; Zaltz, Ira

doi:10.2106/jbjs.15.00798

Cited by 191 publications

(158 citation statements)

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“…The values of the minimal clinically important difference were <11 points for most of the scores evaluated in this study. This is consistent with contemporary studies on periacetabular osteotomy 12,30,31 and a classic study that described the long-term outcomes 32 . The limitations of the distribution-based approach (i.e., strong influence of the population characteristics and possible insensitivity to true differences in patient perception) dictate that future studies also use the anchoring approach.…”

Section: Discussionsupporting

confidence: 90%

“…It must be stressed that the overall change in health is not equal to patients' satisfaction with the surgical procedure (almost one-third of the cohort did not feel improvement in their general health, but a majority of the patients were satisfied with the surgical procedure). Importantly, the satisfaction rates were similar to those reported by other studies 12,34 . Third, since the beginning of our study, which is a part of a multicenter cohort, new patient-reported outcome measures have been developed for patients with hip problems, such as the International Hip Outcome Tool (iHOT-33) and the Copenhagen Hip and Groin Outcome Score (HAGOS) 14,35 .…”

Section: Discussionsupporting

confidence: 88%

“…Multiple studies have shown clinical outcomes of periacetabular osteotomy for developmental dysplasia of the hip utilizing patient-reported outcome measures, without estimating their psychometric properties 4,5,12 . Psychometric properties are useful for understanding the value of patient-reported outcome measures in a specific population.…”

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confidence: 99%

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Psychometric Properties of Patient-Reported Outcome Measures for Periacetabular Osteotomy

Waśko

Yanik

Pascual‐Garrido

et al. 2019

The Journal of Bone and Joint Surgery

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Background: Appropriate patient-reported outcome measures are paramount to determine the clinical relevance of change experienced by patients after a surgical procedure. The purpose of this study was to evaluate the psychometric properties of 3 patient-reported outcome measures (Hip disability and Osteoarthritis Outcome Score [HOOS], modified Harris hip score, and Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]) in a large population of patients treated with periacetabular osteotomy for symptomatic developmental dysplasia of the hip. Methods: Patients who underwent a periacetabular osteotomy for acetabular dysplasia between October 2011 and October 2016 completed multiple questionnaires preoperatively and at the 1-year follow-up. Internal consistency for subscores was evaluated with the Cronbach alpha. Validity was assessed against the Short Form-12. Interpretability included the calculation of the distribution of scores, floor and ceiling effects, and the minimal clinically important difference. Responsiveness was assessed by correlating the score changes with the Global Perceived Effect score. Results: Of 294 patients, 246 (84%) were female. The median age was 21 years (interquartile range, 17 to 29 years). All WOMAC and HOOS subscores demonstrated adequate internal consistency, and none of the modified Harris hip score components did. All scores except the WOMAC stiffness score exhibited adequate validity and interpretability, with no floor and ceiling effects over 15%. For the HOOS subscores, the minimal clinically important difference was 10.3 for pain, 10.2 for symptoms, 12.6 for sports and recreation, 11.2 for quality of life, and 10.8 for activities of daily living. The minimal clinically important difference for the modified Harris hip score was 7.4. For the WOMAC subscores, the minimal clinically important difference was 10.8 for pain, 12.9 for stiffness, 10.8 for physical, and 10.4 for total. All scores demonstrated adequate responsiveness. Conclusions: The HOOS, WOMAC, and modified Harris hip score have adequate psychometric properties for use in patients undergoing periacetabular osteotomy, with minor shortcomings. Among the scores analyzed, the HOOS appears to be the most appropriate measure of patient-reported outcome in patients undergoing periacetabular osteotomy. Clinical Relevance: By establishing the psychometric properties of patient-reported outcome measures for periacetabular osteotomy, this study enables a more informed choice of measures for clinical practice and research. The estimated minimal clinically important difference values will facilitate understanding the importance of change in patient-reported outcomes after a surgical procedure in a clinical setting and sample size calculation for further studies.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 88%

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Psychometric Properties of Patient-Reported Outcome Measures for Periacetabular Osteotomy

Waśko

Yanik

Pascual‐Garrido

et al. 2019

The Journal of Bone and Joint Surgery

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“…Within the ANCHOR group, over 1400 PAOs were performed from 2008–14 and over 1100 FAI surgeries between 2008–11 [18, 19]. Although indications for hip preservation surgery vary, pre-operative pain is the most common [12, 20, 21].…”

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confidence: 99%

Predictors and trajectories of chronic postoperative pain following hip preservation surgery

Sieberg

Klajn

Wong

et al. 2017

Journal of Hip Preservation Surgery

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Factors contributing to chronic postoperative pain (CPOP) are poorly defined in young people and developmental considerations are poorly understood. With over 5 million children undergoing surgery yearly and 25% of adults referred to chronic pain clinics identifying surgery as the antecedent, there is a need to elucidate factors that contribute to CPOP in surgical patients. The present study includes patients undergoing hip preservation surgery at a children’s hospital. The HOOS and SF-12 Health Survey were administered to 614 pre-surgical patients with 421 patients completing follow-up (6-months, 1-year and 2-years post-surgery). Pain, quality of life, and functioning across time were examined for each group within the population. A three trajectory model (low pain, pain improvement and high pain) emerged indicating three categories of treatment responders. Pain trajectory groups did not differ significantly on gender, pre-surgical age, BMI, prior hip surgery, surgical type, joint congruence or Tönnis grade. The groups differed significantly from each other on pre-surgical pain, pain chronicity, quality of life and functioning. Those in the high pain and pain improvement groups endorsed having pre-surgical depression at significantly higher rates and lower pre-surgical quality of life compared to those in the low pain group (P < 0.01). Those in the high pain group reported significantly worse pre-surgical functioning compared to those in the pain improvement (P < 0.0001) and low pain groups (P < 0.0001).The results demonstrate the need for preoperative screening prior to hip preservation surgery, as there may be a subset of patients who are predisposed to chronic pain independent of hip health.

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“…Shelf acetabuloplasty has been reported to result in good long-term outcomes in hip dysplasia with a well-centred femoral head, a VCE angle greater than 0, and minimal osteoarthritis defined as a Tönnis grade ≤ 2 [5][6][7][8][9]. A more invasive peri-acetabular osteotomy technique has also been advocated, despite being associated with complications in up to 10.8% of patients [10].…”

Section: Introductionmentioning

confidence: 99%

Feasibility of a new arthroscopic shelf acetabuloplasty technique for hip instability related to moderate dysplasia

Coulomb

Wolff

Marès

et al. 2019

Orthopaedics & Traumatology: Surgery & Research

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of a new arthroscopic shelf acetabuloplasty technique for hip instability related to moderate dysplasia. Service de chirurgie orthopédique et traumatologique, CHU Carémeau, place du Pr-Debré, 30029 Nimes cedex 9, France Keywords: Hip arthroscopy Shelf acetabuloplasty Hip instability Moderate hip dysplasia a b s t r a c tDysplasia-related hip instability causes pain and intra-articular derangement. The bone, the joint capsule, and the labrum are involved. We describe a surgical procedure of limited invasiveness that corrects the dysplasia by creating an acetabular shelf, repairs the secondary lesions by suturing the labrum and tightening the capsule, and corrects cam femoro-acetabular impingement if present.

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Patient-Reported Outcomes of Periacetabular Osteotomy from the Prospective ANCHOR Cohort Study

Abstract: Background: Current literature describing the periacetabular osteotomy (PAO) is mostly limited to retrospective case

Cited by 191 publications

References 41 publications

Psychometric Properties of Patient-Reported Outcome Measures for Periacetabular Osteotomy

Psychometric Properties of Patient-Reported Outcome Measures for Periacetabular Osteotomy

Predictors and trajectories of chronic postoperative pain following hip preservation surgery

Feasibility of a new arthroscopic shelf acetabuloplasty technique for hip instability related to moderate dysplasia

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