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The impact of early postoperative pain interference on 2-year outcomes after hip arthroscopy
Dominic J Ventimiglia1, Joseph M Blommer2, Michael A McCurdy1
1Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, USA.
Purpose:
The relationship between early postoperative pain and long-term outcomes after hip arthroscopy is unclear. This study examined whether 2-week postoperative pain scores are associated with 2-year patient-reported outcomes (PROs) after hip arthroscopy and compared outcomes between patients with and without early postoperative pain improvement.
Methods:
Patients undergoing hip arthroscopy for labral tear and/or femoroacetabular impingement syndrome were retrospectively identified from a prospectively enrolled registry. Patients completed baseline, 2-week, and 2-year surveys. Patient-reported outcomes measurement information system (PROMIS) pain interference (PI) assessed pain. Early improvement was defined as a change in PROMIS PI score relative to the minimal clinically important difference threshold of ± 3.1 points from baseline at 2 weeks postoperatively. Patient characteristics and PROs were compared between groups by early improvement status.
Results:
Of 136 patients, 95 (71%) completed 2-week follow-up, and 70 of 95 (74%) completed 2-year. Improved early PROMIS PI was associated with worse baseline PROMIS Physical Function (p < .001) and PROMIS PI (p < .001), and better 2-week PROs across nearly all outcomes. Worse 2-week PROMIS PI scores correlated with worse 2-year PROMIS PI (p = .02), Fatigue (p = .02), and Anxiety (p = .002). On multivariable analysis, improved 2-week PROMIS PI was independently associated with better 2-year PROMIS PI, Marx Activity Rating Scale, and greater improvement in PROMIS PI.
Conclusion:
Early improvement in PROMIS PI after hip arthroscopy was independently associated with better 2-year pain and activity outcomes. Patients with improved early postoperative pain had worse baseline pain and function but better early postoperative PROs. 2-week PROMIS PI may serve as a useful prognostic indicator for 2-year PROs after hip arthroscopy.
