Maximal Outcome Improvement Willingness Thresholds Are Predictive of a Patient's Willingness to Undergo the Same Surgery, in Retrospect, Given the Known Outcome of Their Primary Hip Arthroscopy

Maximal Outcome Improvement Willingness Thresholds Are Predictive of a Patient's Willingness to Undergo the Same Surgery, in Retrospect, Given the Known Outcome of Their Primary Hip Arthroscopy

Authors: Maldonado DR, Fox JD, Kyin C, Jimenez AE, Saks BR, Curley AJ, Lall AC, Domb BG
Journal: Arthroscopy Sports Medicine and Rehabilitation, April 2022
DOI: 10.1016/j.asmr.2022.02.004

Background

This study assesses how maximal outcome improvement willingness thresholds (MOWT) correlate with patients’ retrospective willingness to undergo the same hip arthroscopy surgery again, based on outcome scores.

Methods

• Patients with hip arthroscopy and gluteus medius tear repair were surveyed.
• MOWTs for Nonarthritic Hip Score (NAHS) and visual analog scale (VAS) were calculated using ROC curve analysis.

Key Findings

• MOWTs were 54.7% for NAHS improvement and 62.6% for VAS improvement.
• Patients reaching these thresholds had an 85% likelihood of willingness to repeat surgery.

Conclusions

MOWT is a strong predictor of patient willingness to undergo repeat hip arthroscopy, highlighting the importance of achieving substantial functional and pain improvement.

What Does This Mean for Providers

• Use MOWTs as benchmarks during postoperative counseling to assess patient satisfaction and likelihood of endorsing repeat surgery if needed.
• Aim to achieve or exceed these improvement thresholds to maximize patient acceptance and satisfaction.
• Incorporate these metrics into shared decision-making, helping set realistic expectations about outcome goals.
• Consider patient-reported willingness thresholds when evaluating overall surgical success beyond clinical measures.