Arthroscopic procedures are increasingly performed for femoroacetabular impingement (FAI). The Non-Arthroplasty Hip Register (NAHR) collects data including the iHOT12 and EQ5D. However there is currently little evidence of its usefulness in assessing hip arthroscopy outcomes. This study aims to assess minimum 1-year outcomes of hip arthroscopy for FAI using the minimum data set (MDS) of the NAHR by comparing these to a patient satisfaction questionnaire. Pre-operative scores for 78 consecutive hips in 76 patients (43F/33M, mean age at surgery 31.76±10.02 years) undergoing hip arthroscopy for FAI at our institution between February 2013-June 2015 were entered into the NAHR. Insufficient post-operative data was available from the registry. Therefore we collected iHOT12, EQ5D and satisfaction data by postal survey. Preoperative mean iHOT-12 score was 32.67±14.23, median EQ5D Index score 0.653 (IQR 0.277) and median EQ5D Visual Analogue Scale 70 (IQR 25). Postoperative scores were available for 56 cases (55 patients, 71.8%) at median 18.9 months (IQR 13.77). There was a significant postoperative improvement in self-reported outcome as measured by iHOT-12 (mean improvement 35.7 points, p<0.001) and EQ5DIndex scores (median improvement 0.127, p=0.001). 24 patients were very satisfied, 19 satisfied, 6 neutral, 4 dissatisfied and 1 very dissatisfied. Satisfied patients exhibited greater improvement in iHOT-12 (mean 41.64±19.29 vs 2.8±24.08, p<0.001) and EQ5D index scores (p=0.013) but no difference in EQ5D VAS (p=0.15). Improvement in iHOT12 correlated with improvement in EQ5DIndex (r=0.676, p<0.001) and EQ5DVAS(r=0.552, p<0.001). Hip arthroscopy for FAI yielded significant improvements in iHOT-12 and EQ5D index scores and 80% of responders were satisfied/very satisfied at a minimum one year postop. iHOT12 and EQ5DIndex correlated with patient satisfaction and improvements in iHOT12 correlated with improvements in general quality of life. Our findings suggest that the MDS of the NAHR is useful for assessing the outcome in these patients.
Total Hip Replacement (THR) is an effective treatment for end stage degenerative disease of the hip and offers patients the prospect of long term pain relief, improved joint function and quality of life. Enhanced Recovery Programmes (ERP) aim to standardise routine perioperative care, reduce hospital length of stay (LOS) and promote rapid recovery after elective surgery. The aim of this study was to determine whether the implementation of an ERP could successfully reduce the length of hospital stay associated with primary THR and whether this could be achieved without compromising the expected functional outcome or risking an increased dislocation rate. Prospectively collected data on 1161 patients (611 managed with traditional rehabilitation and 550 with ERP) undergoing primary unilateral THR between 2005 and 2013 was retrospectively reviewed. Univariable statistical analysis was undertaken to identify factors that appeared to predict length of stay and a multiple linear regression model was then constructed to determine the significance and strength of effect of the individual predictors.Introduction
Patients/Materials & Methods