Disclosures: Chris Ng, MD, MBA: Nothing to disclose

Objective: To determine which aspects of hip dysfunction are associated with pre-arthritic hip disorder (PAHD) patients’ choice to pursue surgical intervention over conservative management, within 1 year of initial presentation.

Design: Retrospective review

Setting: Outpatient clinic of a tertiary academic orthopedic department.

Participants: Subjects were patients, aged 13-40 years (n=240), who presented with hip pain and were diagnosed with symptomatic femoroacetabular impingement (FAI), acetabular dysplasia, and/or an acetabular labral tear. Patients completed the Hip Disability and Osteoarthritis Outcome Score (HOOS) at initial evaluation. Their decision to pursue conservative management versus surgical intervention within 1 year was recorded.

Interventions: Not applicable

Main Outcome Measures: Mean score differences for the five HOOS constructs between subjects who did versus did not pursue surgery were evaluated using independent two-tailed t-tests. Binary logistic regression models identified constructs predictive of subjects’ choice to pursue surgery after controlling for age and sex.

Results: Of the 240 patients (mean age 24.8 ± 7.7 years), 185 (77%) were female, and 134 (56%) chose surgical over conservative management. Mean scores for all HOOS constructs were worse in patients pursuing surgery by the following magnitudes: quality of life QOL (5.5 points, P =.046), activity (4.7 points, P =.107), pain (4.6 points, P =.096), sports (4.2 points, P =.211), and symptoms (0.8 points, P =.773). When controlling for age and sex, only the HOOS QOL subscale was statistically significant as an independent predictor of PAHD patients’ choice to pursue surgery (B=-0.024, SE=0.00982, P =.0152).

Conclusions: The effect of hip pain on perceived QOL – including general awareness, lack of confidence, and need for lifestyle modifications – is a significant and independent predictor of PAHD patients’ decision to pursue surgical intervention over conservative therapy. Educating patients on the psychological impact and management of pain as it relates to QOL may enable more patients to achieve satisfactory short-term outcomes with non-operative management.

Level of Evidence: Level III

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/what-aspects-of-hip-dysfunction-predict-pre-arthritic-hip-disorder-patients-choice-to-pursue-surgery-over-conservative-care/