Clinically Relevant Thresholds for Hip Arthroscopy Vary: A Systematic Review
Author(s): Walsh EG, Wallace IA, Quesada-Jimenez R, Kahana-Rojkind AH, Domb BG
DOI: 10.1016/j.arthro.2024.12.032
Objective
To evaluate the reported variability in Patient Acceptable Symptom State (PASS) and Substantial Clinical Benefit (SCB) thresholds following hip arthroscopy using various patient-reported outcome measures (PROMs).
Methodology
A systematic review of 35 studies analyzing PASS and SCB across 13 different PROMs in hip arthroscopy literature. Only studies involving intra-articular hip pathology and Level I–IV evidence were included.
Key Findings
- Threshold values for PASS and SCB vary considerably depending on PROM type, study design, patient population, follow-up duration, and definitions of improvement.
- PASS thresholds for sport-related function (e.g., HOS-SSS) ranged from 63.9 to 86.8.
- SCB thresholds for tools like the iHOT varied from 66.7 to 87.5.
Conclusion
There is no universal benchmark for defining clinical success in hip arthroscopy. Surgeons should interpret outcome scores within the context of individual patient factors, follow-up timelines, and selected PROMs.
What Does This Mean for Providers?
Clinicians should be cautious when using PASS and SCB thresholds to guide decision-making or assess success following hip arthroscopy. These values are highly dependent on study parameters and may not generalize across populations or clinical scenarios. When counseling patients and evaluating progress, providers should individualize expectations and recognize that standardized PROM benchmarks may not accurately reflect each patient’s experience or satisfaction.