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Lack of validated patient-reported outcome tools persists in paediatric and adolescent hip arthroscopy-A systematic
Ayomide Michael Ade-Conde1, Brendan Amoyaw2, Yoan Bourgeault-Gagnon3
1School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland.
Insights
Paediatric hip arthroscopy lacks validated, specific patient-reported outcome tools, relying on adult instruments. Developing and validating age-appropriate tools is crucial for accurate outcome assessment in young patients.
Area of Science:
- Orthopaedic surgery
- Paediatric orthopaedics
- Health outcomes research
Background:
- Patient-reported outcomes (PROs) are vital for assessing treatment effectiveness in paediatric hip arthroscopy.
- Current literature shows a reliance on adult-derived PRO instruments for this population.
- There is a need to evaluate the validation status of PROs used in paediatric hip surgery.
Purpose of the Study:
- To identify patient-reported outcome (PRO) tools commonly used in paediatric hip arthroscopy.
- To assess the formal validation of these PRO tools in the paediatric population.
Main Methods:
- Systematic literature searches were conducted in MEDLINE, Embase, and CENTRAL.
- Studies involving hip arthroscopy in patients aged 19 and under were identified.
- PRO instruments and their clinimetric properties were analyzed, with a focus on paediatric hip arthroscopy.
Main Results:
- Fifty-seven studies identified 10 hip-specific and 5 non-specific PROs.
- The modified Hip Harris Score, Hip Outcome Score-Sport-Specific Subscale, and Non-Arthritic Hip Score were most common.
- No clinimetric studies validating these tools in paediatric hip arthroscopy were found.
Conclusions:
- There is a significant lack of validated, hip-specific PRO tools for paediatric hip arthroscopy.
- Existing instruments are often adult-derived and lack paediatric-specific validation.
- Standardized, validated paediatric-specific PRO tools are needed for accurate outcome assessment.
Purpose:
This systematic review aimed to (1) identify commonly used patient-reported outcome (PRO) tools in paediatric hip arthroscopy and (2) assess whether the PROs used in this population have been formally validated.
Methods:
Two systematic searches of MEDLINE, Embase and CENTRAL, from inception to 31 March 2024 and 22 August 2024, respectively, followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The first search identified PRO instruments used in studies on hip arthroscopy in patients aged 19 and under. The second focused on the clinimetric properties of these tools in paediatric hip arthroscopy. PRO utilization was stratified by pathology, trends over time and publication type. Use of the Consensus-based Standards for the Selection of Health Measurement Instruments tool, and a descriptive analysis, were planned to assess the eligible clinimetric studies.
Results:
Fifty-seven studies were included, identifying 10 hip-specific and 5 nonspecific PROs. The second search did not identify any clinimetric studies on these tools used in paediatric patients. The most commonly reported hip-specific PRO were the modified Hip Harris Score (n = 48), the Hip Outcome Score-Sport-Specific Subscale (n = 25) and the Non-Arthritic Hip Score (n = 20). Hip arthroscopy was used to treat over seven different conditions, with femoroacetabular impingement being the most common (n = 41, 77%). Between 2005 and 2024, the variety of hip-specific PROs increased, with seven new ones introduced by 2019-2024. Additionally, this study found a relatively equal distribution of outcomes across presentation abstracts and manuscripts.
Conclusions:
The key finding of this study is the ongoing lack of hip-specific PRO tools in the paediatric hip arthroscopy literature, with reliance on adult-derived instruments. The absence of clinimetric studies and heterogeneity in PRO use emphasises the need for standardized, paediatric-specific tools. Developing and validating such instruments should be prioritized to ensure accurate, age-appropriate outcome assessment and care.
Level Of Evidence:
Level III.
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