Predictors of Achieving the Maximal Outcome Improvement Threshold for Willingness to Undergo Revision Hip Arthroscopy
Authors: Maldonado DR, Kyin C, Owens JS, Rosinsky PJ, Jimenez AE, Lee MS, Domb BG
Journal: American Journal of Sports Medicine, July 2022
DOI: 10.1177/03635465221096872
Background
This study aims to identify predictive factors associated with achieving the maximal outcome improvement threshold (MOWT) in patients undergoing revision hip arthroscopy. The MOWT correlates with patient satisfaction and willingness to undergo the same surgery again.
Methods
- Patients who underwent revision hip arthroscopy with completed pre- and postoperative PROMs were analyzed.
- MOWTs were defined for mHHS, NAHS, and VAS.
- Logistic regression models were used to identify predictors of MOWT achievement.
Key Findings
- 77.3% of patients who met the MOWT for all three PROMs (mHHS, NAHS, VAS) would opt to have the surgery again.
- Residual cam-type morphology before revision was associated with 2.3x higher odds of achieving the MOWT for VAS.
- Patient satisfaction correlated strongly with meeting threshold improvements across measures.
Conclusions
Meeting specific MOWT values correlates with high patient satisfaction and retrospective willingness to undergo revision surgery. Certain preoperative factors, like residual cam deformity, may positively influence outcomes.
What Does This Mean for Providers?
Clinicians should consider preoperative factors like residual cam morphology when counseling patients about revision hip arthroscopy. Achieving MOWT is a useful benchmark for predicting postoperative satisfaction and patient-perceived value of surgery.