The pre-operative physical component subscale of the 12-item Short Form Health Survey was the only factor associated with 2-year clinical outcome and satisfaction after hip abductor tendon repair.

INTRODUCTION

Surgical repair in the context of symptomatic hip abductor tears unresponsive to non-operative management has demonstrated encouraging outcomes. This study sought to investigate demographic, injury/management and post-operative factors associated with clinical outcome after hip abductor tendon repair.

METHODS

A total of 104 patients undergoing repair were included. Patients were assessed pre-surgery and 2-years post-operatively with the modified Harris Hip Score (mHHS), Oxford Hip Score (OHS), physical (PCS) and mental (MCS) component subscales of the 12-item Short Form Health Survey (SF-12), and satisfaction. Regression analysis assessed the contribution of pre-operative demographic (age, sex, body mass index, PCS, MCS), injury/treatment (symptom duration, prior corticosteroid injections, gluteus minimus/medius tear grade and fatty infiltration) and post-operative (hip abduction strength symmetry) variables, to the 2-year mHHS and being 'very satisfied'.

RESULTS

Mean improvement in the mHHS and OHS from baseline to 2 years was 36.0 points (95% CI, 31.9 to 40.2; p < 0.001) and 17.5 points (95% CI, 15.8 to 19.3; p < 0.001), respectively. Seven (6.7%) patients presented with symptomatic re-tearing. Of the 97 patients with 2-year follow-up, 78 (80.4%) were 'very satisfied'. The pre-operative SF-12 PCS was the only factor associated with the 2-year mHHS (B = 0.46; 95% CI, 0.15 to 0.77; β = 0.285; p = 0.004; adjusted R2 = 0.072), and being 'very satisfied' (OR = 1.10; 95% CI, 1.01 to 1.19; p = 0.021). Lower baseline SF-12 PCS scores were observed in those that presented with symptomatic re-injuries (26.7 ± 5.6 vs 34.8 ± 8.0; p = 0.007), though no other characteristics differed.

CONCLUSIONS

All clinical outcomes improved following surgery. The pre-operative SF-12 PCS was the only variable associated with outcome and satisfaction, though this association was weak and the explanatory capacity of these models was low. This indicates that the majority of outcome variability remains unexplained by the variables assessed, further questioning the clinical significance of the pre-operative SF-12 in patient selection.

LEVEL OF EVIDENCE: Level IV, prospective case series.