The Influence of Lumbosacral Spine Pathology on Minimum 2-Year Outcome After Hip Arthroscopy: A Nested Case-Control Analysis

被引:24
作者
Beck, Edward C. [1 ]
Nwachukwu, Benedict U. [2 ]
Chapman, Reagan [2 ]
Gowd, Anirudh K. [1 ]
Waterman, Brian R. [1 ]
Nho, Shane J. [2 ]
机构
[1] Wake Forest Sch Med, Dept Orthoped Surg, 1 Med Ctr Blvd, Winston Salem, NC 27101 USA
[2] Rush Univ, Med Ctr, Dept Orthoped Surg, Chicago, IL 60612 USA
关键词
lumbosacral pathology; minimal clinically important difference; hip arthroscopy; femoracetabular impingment; lumbar spine; SUBSTANTIAL CLINICAL BENEFIT; FEMOROACETABULAR IMPINGEMENT; LUMBAR SPINE; IMPORTANT DIFFERENCE; CAPSULAR CLOSURE; ARTHROPLASTY; PAIN; DISEASE; SURGERY; IMPACT;
D O I
10.1177/0363546519892916
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: Previous literature has examined the association between lumbosacral pathology and hip pathomechanics. However, the effect of lumbosacral pathologies and previous lumbosacral surgery on achieving meaningful outcomes after hip arthroscopy for femoroacetabular impingement syndrome (FAIS) has yet to be studied conclusively. Purpose: To determine whether a history of lumbosacral spine pathology has an influence on achieving minimal clinically important differences (MCIDs) after hip arthroscopy for FAIS. Study Design: Cohort study; Level of evidence, 3. Methods: Patients undergoing hip arthroscopy for FAIS by a single, fellowship-trained orthopaedic surgeon between January 2012 and April 2017 with minimum 2-year follow-up were retrospectively reviewed. Patients with a history of lumbosacral spine pathology (eg, lumbosacral fusion, disc or vertebral pathology, or history of lumbosacral fractures) were matched 1:2 by age, body mass index, and sex to patients without spine pathology. Clinical outcomes including the Hip Outcome Score-activities of daily living subscale (HOS-ADL), HOS-sports subscale (HOS-SS), modified Harris Hip Score (mHHS), international Hip Outcome Tool-12 (iHOT-12), visual analog scale (VAS) pain, and VAS satisfaction were compared between the groups using an independent t test. The threshold of every outcome score for achieving MCID was calculated separately for each group and frequencies were compared. Results: A total of 83 of 108 eligible patients with lumbosacral pathology were identified and matched to 166 patients without any spine pathology. When compared with the non-spine pathology group, the lumbosacral pathology group had significantly lower 2-year postoperative outcome score averages across all reported outcome tools (all P < .001). There were significant differences in the proportion achieving the threshold for HOS-ADL (60.6% vs 80.0%; P = .004), HOS-SS (57.6% vs 82.1%; P < .001), mHHS (66.7% vs 81.7%; P = .025), and iHOT-12 (54.8% vs 87.6%; P < .001) scores for MCID when comparing the lumbosacral and nonlumbosacral pathology groups. Conclusion: Patients with a history of lumbosacral pathology achieved significantly lower short-term meaningful clinical outcomes after undergoing hip arthroscopy for FAIS when compared with patients without spine pathology. The present study findings have implications for preoperative patient screening, shared decision-making processes/expectation management, and rehabilitation strategies.
引用
收藏
页码:403 / 408
页数:6
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