The Patient Acceptable Symptomatic State of the 12-Item International Hip Outcome Tool at 1-Year Follow-Up of Hip-Preservation Surgery

Purpose: To determine the patient acceptable symptomatic state (PASS) cutoff score for the 12-item International Hip Outcome Tool (iHOT-12) for patients after hip-preservation surgery. Methods: A multicenter hip arthroscopy registry containing deidentified patient data was analyzed to discriminate patients who achieved satisfactory results from patients who did not. Patients eligible for inclusion in the study were between 18 and 75 years of age, consented to undergo elective hip arthroscopy, and completed preoperative patient-reported outcome questionnaires. A receiver operating characteristic analysis was performed to determine the PASS cutoff score for the iHOT-12 at 1 year after surgery based on the sensitivity and specificity of achieving satisfaction with surgery. A visual analog scale rating patient satisfaction 1 year after surgery was documented and compared between subjects who achieved the PASS score for the iHOT-12 and those who did not achieve it through an independent t test with an a priori alpha set at .05. Results: A total of 647 subjects (66% women) aged between 18 and 73 years (mean, 36.5 years; standard deviation [SD], 12.0 years) were included in the study. A cutoff score of 75.2 for the iHOT-12 yielded a sensitivity of 0.91 and specificity of 0.81. Satisfaction averaged 89.5% (SD, 18.0%) for the patients with iHOT-12 scores greater than the PASS cutoff score versus 60.9% (SD, 30.61%) for those who did not achieve the PASS iHOT-12 score. Conclusions: The PASS cutoff score of 75.2 for the iHOT-12 establishes a "minimal" target score at which the patient is highly likely to be satisfied with the physical state of his or her hip joint at 1 year after hip arthroscopy. Level of Evidence: Level III, case-control study.