| The early outcome of surgical treatment for femoroacetabular impingement: success depends on how you measure it. | |
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MedLine Citation:
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PMID: 22469846 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate the proportion of "successes" after surgery for femoroacetabular impingement using different external criteria, "feeling better" and "feeling good", and to determine the corresponding cut-off scores indicating "success" for the WOMAC (0 to 10-point response scale), Oxford Hip Score (OHS) and EuroQoL-5D (EQ-5D and EQ-VAS).Design: Prospective, observational study based in an orthopaedic hospital. Ninety-nine consecutive patients with femoroacetabular impingement (FAI) completed the questionnaires before and 6 months after surgery (arthroscopy or mini-open surgical dislocation). Patient-ratings of change in state ("feeling better") were assessed using a global treatment outcome (GTO) item. Acceptability of the current health state was assessed using the symptom-specific well-being (SSWB) item. Cut-off (threshold) scores for the different instruments indicating the minimal clinically important change (MCIC) and acceptable symptom state were calculated using Receiver Operating Characteristics (ROC) analyses. RESULTS: Significant improvements in all scores (p<0.001) were recorded 6 months after surgery. The proportion of good outcomes measured with GTO was 60%; 55% of patients reported having achieved an acceptable symptom state. The MCIC scores for improvement were ≥6 for the Oxford Hip Score (0-48 total score range), ≥15 for EQ-VAS, ≥0.16 for EQ-5D index, and ≥22 for the WOMAC-total score (0-100 total score range); absolute scores of ≥40, ≥80, ≥0.682 and ≤8, respectively, were associated with an acceptable symptom state. CONCLUSIONS: The results show that feeling better does not always equate to feeling good, and that improvements in outcome scores, even large, do not necessarily indicate acceptability of the current state. The cut-off values may help in the interpretation of trial results and individual change-scores recorded in clinical practice. |
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Authors:
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Franco M Impellizzeri; Anne F Mannion; Florian D Naal; Otmar Hersche; Michael Leunig |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-3-30 |
Journal Detail:
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Title: Osteoarthritis and cartilage / OARS, Osteoarthritis Research Society Volume: - ISSN: 1522-9653 ISO Abbreviation: - Publication Date: 2012 Mar |
Date Detail:
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Created Date: 2012-4-3 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9305697 Medline TA: Osteoarthritis Cartilage Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012. Published by Elsevier Ltd. |
Affiliation:
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Department of Research and Development, Schulthess Clinic, Zurich, Switzerland. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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