Minimal Clinically Important Difference and Substantial Clinical Benefit After Revision Hip Arthroscopy

Area of Science:

• Orthopedics
• Sports Medicine
• Hip Surgery

Background:

• Revision hip arthroscopy is increasingly performed for persistent hip pain and dysfunction.
• Establishing clear outcome benchmarks is crucial for patient management and surgical evaluation.
• Minimal clinically important difference (MCID) and substantial clinical benefit (SCB) provide valuable metrics for assessing treatment success.

Purpose of the Study:

• To define the MCID and SCB for key patient-reported outcome measures (PROMs) in revision hip arthroscopy.
• To identify predictors of achieving MCID and SCB in this patient population.

Main Methods:

• Prospective study of 49 revision hip arthroscopy patients.
• Utilized modified Harris Hip Score (mHHS), Hip Outcome Score (HOS), and international Hip Outcome Tool (iHOT-33).
• Defined MCID using distribution-based methods and SCB using anchor-based responses at 1-year follow-up.

Main Results:

• MCID values varied by score: mHHS (7.9), HOS ADL (7.9), HOS Sports (13.1), iHOT-33 (12.8).
• SCB net change ranged from 16.2 (HOS ADL) to 25.5 (iHOT-33).
• Patients with residual femoroacetabular impingement (FAI) showed higher MCID achievement; preoperative scores predicted SCB.

Conclusions:

• Established MCID and SCB values for commonly used PROMs in revision hip arthroscopy.
• Residual FAI was the most common indication and associated with better outcomes.
• These benchmarks aid in interpreting patient outcomes after revision hip surgery.