The relationship between pre-operative pain characteristics and periacetabular osteotomy outcomes in patients with acetabular dysplasia

Everett, Brandon P; Nakonezny, Paul A.; Mulligan, Edward P.; Chhabra, Avneesh; Wells, Joel

doi:10.1093/jhps/hnac004

Cited by 4 publications

(8 citation statements)

References 37 publications

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“…The minimal clinically important difference (MCID) values used in this study for mHHS, HOS, and iHOT-12 are 8.0, 6.0, and 13.0, respectively. 11,17,18 Patients marked their locations of pain on questionnaires (Figure 2). Pain could be located in the groin, anterior thigh, knee, lower back, buttock, posterior thigh, trochanter, and/or lateral thigh.…”

Section: Methodsmentioning

confidence: 99%

“…Location of maximum pain severity, number of pain locations, maximum severity of pain, modified Harris Hip Score (mHHS), 14 Hip Outcome Score (HOS), 15 and international Hip Outcome Tool (iHOT-12) 16 were assessed by patient self-reported hip questionnaires completed at preoperative and postoperative visits. 11 Postoperative outcome measures were recorded at the most recent follow-up appointment. The mHHS, HOS, and iHOT-12 all range on a scale of 0 to 100, with 100 being the highest possible score for each outcome measure.…”

Section: Methodsmentioning

confidence: 99%

“…Pain could be located in the groin, anterior thigh, knee, lower back, buttock, posterior thigh, trochanter, and/or lateral thigh. In addition, patients noted the severity of pain at each location based on the following, previously reported scale: 11 , 19 - 21 0 = no pain, 1 = pain with extreme activity only (running, excessive walking, etc. ), 2 = pain with moderate activity or specific movements only (getting in/out of a chair or car; going up/down stairs), 3 = pain with daily activities (bathing, getting dressed, going to bathroom, etc.…”

Section: Methodsmentioning

confidence: 99%

“…The minimal clinically important difference (MCID) values used in this study for mHHS, HOS, and iHOT-12 are 8.0, 6.0, and 13.0, respectively. 11 , 17 , 18 …”

Section: Methodsmentioning

confidence: 99%

“…This correlation has been examined in patients who received periacetabular osteotomy for acetabular dysplasia, and no significant relationship between preoperative pain characteristics and postoperative outcome measures was found. 11 Understanding the relationship between preoperative pain characteristics and postoperative THA outcomes is important to help patients and orthopaedic surgeons determine who is most likely to benefit from THA as the demand continues to increase.…”

Section: Introductionmentioning

confidence: 99%

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The relationship between patient-reported outcomes and preoperative pain characteristics in patients who underwent total hip arthroplasty

et al. 2022

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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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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…The minimal clinically important difference (MCID) values used in this study for mHHS, HOS, and iHOT-12 are 8.0, 6.0, and 13.0, respectively. 11 , 17 , 18 …”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The relationship between patient-reported outcomes and preoperative pain characteristics in patients who underwent total hip arthroplasty

et al. 2022

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"Exploring the Impact of Preoperative Radiographic Arthritis Severity on Total Hip Arthroplasty Outcomes" Can patients with less radiographic hip disease still do well after a THA?

Amado,

Bialazewski,

Laboret

et al. 2024

Preprint

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Background As total hip arthroplasty (THA) indications continue to expand and longevity increases, it is important to understand the outcomes in different patient populations. Younger, more active patients are electing to proceed with THA with differing severity of disease. We aimed to investigate patient reported outcome measures (PROMs) in patients who underwent THA with less severe radiographic hip arthrosis.Methods Pre- and post-operative PROMs and radiographic data (joint-space width, Tonnis grade) for patients undergoing THA between 9/16/2016 and 10/21/2021 by a single surgeon were collected. Baseline Tonnis grades were stratified, and PROMs, including Harris Hip Score (HHS), Hip Outcome Score (HOS), and Short-Form-12 Scale (SF-12), were compared pre- and post-operatively.Results Four-hundred and sixty-two hips underwent analysis. Pre-operative HHS following THA were 46.6 ± 11.9, 47.5 ± 11.4, 44.4 ± 9.6, and 42.1 ± 10.7 for Tonnis grades 0 (n = 27), 1 (n = 56), 2 (n = 73), and 3 (n = 306), respectively; while post-operative HHS were 86.4 ± 7.8, 88.4 ± 7.7, 89.5 ± 4.4, and 88.7 ± 5.4 Higher postoperative HOS scores were seen in Tonnis grade 0 and 1, when compared to Tonnis grades 2, and 3 (49.1 ± 27.9, and 50.1 ± 20.8 vs. 47.0 ± 22.2, and 44.0 ± 22.2, respectively; p = 0.003), however, no statistical difference was seen in mean difference HOS (p = 0.447). For SF-12, the mean improvement in order of increasing Tonnis grades was 16.7 ± 48.7, 9.2 ± 38.3, 6.6 ± 43.4, and 14.9 ± 45.2 with no statistical significance observed (p = 0.565).Conclusion In patients undergoing THA, post-operative HHS scores are similar regardless of baseline radiographic severity. Post-operative change in HOS and SF-12 scales was consistently higher across all baseline Tonnis grades prior to THA, while mean change remained comparable. These findings suggest although preoperative radiographic data aids in the evaluation of patients with hip pain, the severity of findings should not determine surgical candidacy. This study challenges radiographic severity for THA eligibility and adds to THA literature for those with less severe radiographic findings.

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Pre- and Post-Operative Pain Intensity and Physical Activity Levels in Individuals with Acetabular Dysplasia Undergoing Periacetabular Osteotomy: A Prospective Cohort Study

Alrashdi,

Motl,

Aguiar

et al. 2024

International Journal of Sports Physical Therapy

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Background Acetabular dysplasia (AD) causes pain, limited function, and development of early hip osteoarthritis. Periacetabular osteotomy (PAO) is a surgical treatment for AD that aims to reposition the acetabulum to reduce pain and improve function. Purpose To examine pain recovery and physical activity (PA) before and during the six months after PAO. Study Design Case series, prospective Methods Individuals with AD scheduled for PAO were enrolled. Pain intensity was evaluated before PAO and at one week and one, three, and six months following PAO. PA levels was evaluated before and six months following PAO using accelerometers (time spent in sedentary behavior, light PA, moderate-to-vigorous PA [MVPA], and daily steps) and the International Physical Activity Questionnaire (IPAQ; time spent in walking and in MVPA). Pain improvements was examined over time following PAO using a repeated-measures one-way ANOVA as well as improvements in PA levels before and six months after PAO using paired-sample t tests. In addition, time spent in MVPA was qualitatively summarized at each time point (before and six months after PAO) measured by both the accelerometers and IPAQ. Results Out of 49 screened participants, 28 were enrolled, and 23 individuals (22 females; age=23.1±7.9 years) completed both study visits. Compared to pre-PAO pain, participants reported significant improvements in pain at one month and onward following PAO (p<0.011). However, PA levels at six months following PAO did not differ from pre-PAO PA levels (p>0.05). Qualitatively, participants reported spending more time in MVPA recorded by the IPAQ (pre-PAO=73.3±150.2 mins/day; six-months after PAO=121.2±192.2 mins/day), compared with MVPA recorded by accelerometers (pre-PAO=22.6±25.2 mins/day; six-months after PAO=25.0±21.4 mins/day). Conclusions Individuals with AD reported significant pain reduction at one month and up to six months after PAO, but PA levels did not change six months after PAO compared to baseline testing. Future studies should consider examining longitudinal pain recovery and PA improvements over longer periods of time with larger samples of individuals with AD undergoing PAO and identifying modifiable factors to minimize pain and increase PA participation. Level of Evidence III

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The relationship between pre-operative pain characteristics and periacetabular osteotomy outcomes in patients with acetabular dysplasia

Cited by 4 publications

References 37 publications

The relationship between patient-reported outcomes and preoperative pain characteristics in patients who underwent total hip arthroplasty

The relationship between patient-reported outcomes and preoperative pain characteristics in patients who underwent total hip arthroplasty

"Exploring the Impact of Preoperative Radiographic Arthritis Severity on Total Hip Arthroplasty Outcomes" Can patients with less radiographic hip disease still do well after a THA?

Pre- and Post-Operative Pain Intensity and Physical Activity Levels in Individuals with Acetabular Dysplasia Undergoing Periacetabular Osteotomy: A Prospective Cohort Study

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