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Vol. 23. Issue 5.
Pages 402-411 (01 September 2019)
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Vol. 23. Issue 5.
Pages 402-411 (01 September 2019)
Original Research
DOI: 10.1016/j.bjpt.2018.09.008
Associations between type and severity of hip pathology with pre-operative patient reported outcome measures
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Matthew D. Frekea,c,
Corresponding author
matthew.freke@uqconnect.edu.au

Corresponding author at: Physiotherapy Department, Enoggera Health Centre, Gallipoli Barracks, Enoggera, Brisbane, Queensland 4060, Australia.
, Kay M. Crossleyb, Trevor Russellc, Kevin J. Simsc,d, Adam Semciwb,c
a Enoggera Health Centre, Gallipoli Barracks, Enoggera, Queensland, Australia
b School of Allied Health, College of Science, Health and Engineering, La Trobe University, Bundoora, Australia
c School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
d Cricket Australia, Albion, Queensland, Australia
Highlights

  • Associations between type and severity of hip pathology with pre-operative patient reported outcome measures were investigated.

  • High prevalence of labral pathology and acetabular chondropathy were observed.

  • Severe femoral head chondropathy and large labral tears are often undetected with imaging.

  • Severe chondropathies are most associated with PROs; however only explain 22% of the variability.

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Figures (2)
Tables (3)
Table 1. Characteristics of participants.
Table 2. Univariable linear regression: crude, unadjusted estimates (regression coefficients 95% CI) of the association between PRO subscales and pathology and demographics.
Table 3. Multivariable backwards stepwise regression: adjusted estimates (95% CI) of the association between PRO subscales and pathology and demographics.
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Abstract
Background

The relationship between hip pathology and patient reported outcome responses following hip surgery has been previously investigated. No studies have investigated the relationship between pathology and patient reported outcome responses prior to surgery.

Objectives

(1) Determine the prevalence of chondral and labral pathology identified during hip arthroscopy. (2) Determine the association between intra-articular findings and patient reported outcome scores in a pre-arthroscopy hip pain population.

Methods

Sixty-seven (22 female) participants scheduled for hip arthroscopy after clinical examination and radiographic assessment completed a series of patient reported outcomes (Hip Disability and Osteoarthritis Outcome Score; International Hip Outcome Tool; Pain on Activity; Visual Analogue Scale). Pathology discovered/addressed during arthroscopy was classified. Univariable and multivariable linear regression models were used to assess the relationship between demographics, pathology and patient reported outcome responses.

Results

Ninety-one percent of participants had labral pathology; 76% had acetabular chondropathy and 31% had femoral head chondropathy. Across the ten patient reported outcome subscales, severe femoral head chondropathy and large labral tears had the greatest number of significant associations with patient reported outcome scores. The strongest association was with ‘Hip Disability and Osteoarthritis Outcome Score symptoms and stiffness’ subscale, where severe femoral head chondropathy explained 22% of variability in symptoms and stiffness, when adjusted for Body Mass Index and presence of pincer morphology (p=0.002).

Conclusion

Severe femoral head chondropathy and large labral tears along with a high prevalence of labral pathology and acetabular chondropathy were relatively common findings during hip arthroscopy. Severe femoral head chondropathy and large labral tears are most associated with patient reported outcome's, however, at best only explain 22% of the variability.

Keywords:
Hip arthroscopy
Patient reported outcomes
Cartilage pathology

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