Revision Hip Arthroscopy Patient Acceptable Symptom State Thresholds at Minimum 5-Year Follow-Up Show Imperfect Agreement With Patient Satisfaction.

PURPOSE: To report patient acceptable symptom state (PASS) thresholds at a minimum 5-year follow-up after revision hip arthroscopy for the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), visual analog scale (VAS), and International Hip Outcome Tool-12 (iHOT-12) and to evaluate the agreement between PASS classification and patient-reported satisfaction.

METHODS

Prospectively collected data were retrospectively reviewed for all patients who underwent revision hip arthroscopy between 2008 and 2018 for persistent femoroacetabular impingement symptoms. Patients were included in the study if they had preoperative and minimum 5-year postoperative scores for mHHS, NAHS, VAS, and iHOT-12 with anchor questions. Patients were excluded if they had Workers' Compensation claims, osteoarthritis, or conversion to total hip arthroplasty. Thresholds for achieving PASS were determined using receiver-operating characteristic curve analysis. Agreement between PASS classification and patient-reported satisfaction was also evaluated.

RESULTS

A total of 94 patients (94 hips) who underwent revision hip arthroscopy met the inclusion criteria, and 60 (64%) completed the satisfaction anchor at minimum 5-year follow-up. Achievement PASS rates were 63.3% for mHHS, 60.0% for NAHS, 75.0% for VAS, and 61.7% for iHOT-12. Area under the curve values from receiver-operating characteristic curves were 0.862 for mHHS, 0.802 for NAHS, 0.873 for VAS, and 0.877 for iHOT-12. PASS values were determined to be 71.0 for mHHS (sensitivity 83.3%, specificity 83.3%), 72.5 for NAHS (76.2%, 77.8%), 4.9 for VAS (95.2%, 72.2%), and 54.7 for iHOT-12 (83.3%, 88.9%). Among patients reporting satisfaction, 18.3% failed to meet at least 1 PASS threshold, whereas 5% of patients exceeded PASS thresholds despite reporting dissatisfaction.

CONCLUSIONS

Thresholds for PASS of commonly used PROs were identified at minimum 5-year follow-up after revision hip arthroscopy. However, imperfect agreement between PASS classification and satisfaction was observed.

LEVEL OF EVIDENCE: Level IV, retrospective case series.