Correlation of the Single-Assessment Numeric Evaluation (SANE) Score With Hip-Specific Patient-Reported Outcome Measures

Short-term Outcomes After Hip Arthroscopic Surgery in Patients Participating in Formal Physical Therapy Versus a Home Exercise Program: A Prospectively Enrolled Cohort Analysis

BACKGROUND

Physical therapy is frequently utilized in the postoperative care of femoroacetabular impingement syndrome (FAIS). There has been limited research into the efficacy of a structured home exercise program (HEP) compared with formal physical therapy (FPT) in this patient population.

PURPOSE/HYPOTHESIS

The purpose was to evaluate the short-term outcomes of patients utilizing FPT versus an HEP after hip arthroscopic surgery for FAIS. It was hypothesized that both groups would show similar improvements regarding outcome scores, which would improve significantly compared with their preoperative scores.

STUDY DESIGN

Cohort study; Level of evidence, 2.

METHODS

Patients undergoing hip arthroscopic surgery for FAIS at a single center between October 2020 and October 2021 were prospectively enrolled. Patients were allowed to self-select FPT or an HEP and were administered a survey preoperatively and at 1 month, 3 months, 6 months, and 12 months postoperatively. The survey included the Single Assessment Numeric Evaluation, visual analog scale for pain, 12-item International Hip Outcome Tool, Patient-Reported Outcomes Measurement Information System Physical Function, and patient satisfaction with physical therapy and overall care. Statistical analysis was conducted between the 2 groups and within groups to compare preoperative and postoperative scores.

RESULTS

The patients' mean age was 32.6 ± 10.4 years, with 47.2% being female and 57.4% choosing the HEP. At 12 months postoperatively, no significant differences were reported between the FPT and HEP groups regarding the Single Assessment Numeric Evaluation score (P = .795), visual analog scale for pain score (P > .05), Patient-Reported Outcomes Measurement Information System Physical Function T-score (P = .699), 12-item International Hip Outcome Tool score (P = .582), and patient satisfaction (P > .05). Outcome scores at 12 months postoperatively were significantly improved from the preoperative scores across all measures in both groups (P < .001).

CONCLUSION

There were no significant differences regarding patient outcomes between FPT and the HEP at 1-year follow-up after hip arthroscopic surgery for FAIS when patients selected their own treatment, with both groups demonstrating significant improvements in their outcome scores from their preoperative values. These findings suggest that a structured HEP may be a viable alternative to FPT after hip arthroscopic surgery in patients who prefer a self-directed rehabilitation program.

Endoscopic Tendon Release for Iliopsoas Impingement After Total Hip Arthroplasty-Excellent Clinical Outcomes and Low Failure Rates at Short-Term Follow-Up

PURPOSE

To investigate the clinical effectiveness of endoscopic iliopsoas tendon release (IPR) at the lesser trochanter (LT) in patients with iliopsoas impingement (IPI) after total hip arthroplasty (THA).

METHODS

Between November 2017 and March 2021, a consecutive series of 36 patients were treated with endoscopic IPR for diagnosed IPI. Patients included had acetabular cup position confirmed by functional imaging (OPS, Corin, Pymble, NSW), typical clinical symptoms of IPI, and a positive response to diagnostic injection. Clinical assessment included validated patient-reported outcome measures (PROMs) along with hip flexion strength and active range of motion at different time marks up to 2-year follow-up, as well as surgical complications.

RESULTS

Overall, 36 consecutive patients (11 males) with a mean age of 62 ± 12 years were included. All patients had failed nonoperative management. Dynamic computed tomography assessment was available in 89% of the patients, edge loading was reported in 10%, and variable cup overhang was reported in 50%. Clinically, PROMs were significantly improved at every time mark when compared with preoperative values (P < .001), showing the biggest improvement within the first 4 weeks after surgery. At the 6-month follow-up, peak isometric hip flexion strength on the operated side was 20% lower than the contralateral side (P < .001). Failure rate of the procedure was 2.8% (1 case). Linear regression showed no association between cup overhang and clinical outcomes.

CONCLUSIONS

Endoscopic IPR at the LT is a safe and reproducible technique associated with significant and immediate improvement in pain, functional outcomes, and high patient satisfaction. With minimal short-term weakness, no complications, and only a single revision, even in cases with cup malposition and/or edge loading, we believe that endoscopic IPR can be considered as one of the first-line operative options in patients with symptomatic IPI, irrespective of component position.

LEVEL OF EVIDENCE

Level IV, case series.

The association of ICUC trauma score and quick DASH in a distal radius fracture cohort

BACKGROUND

This study evaluates the association between ICUC trauma and short-form Disabilities of the Arm, Shoulder, and Hand Questionnaire (Quick DASH) scores among patients who underwent surgery for distal radius fractures.

METHODS

This research gathered patient-reported outcomes (PROs) from patients registered in the ICUC database at a single trauma center. The study involved 76 adult patients who underwent surgical treatment for distal radius fractures before 2023. These patients received a volar locking plate for their distal radius fracture. The research utilized two different PROs to evaluate the patients' conditions. The ICUC trauma score measures functional impairment and pain through two 5-point scale questions, allowing patients to self-assess these aspects. The Quick DASH, comprising 11 questions, was used to evaluate symptoms and functionality of the upper extremity.

RESULTS

For patients aged 55.9 ± 15.3 years and 4.6 ± 3.9 years post-op follow-up, the ICUC trauma score was 0.70 ± 0.95, and Quick DASH was 6.07 ± 10.35. A strong correlation between ICUC and Quick DASH was identified (r = 0.71, P < 0.01). The interaction between the ICUC trauma score and age at the surgery to Quick DASH revealed a significant unstandardized partial regression coefficient of 0.19 (95% confidence interval 0.08-0.31; P < 0.01).

CONCLUSION

This study demonstrated a strong correlation between the ICUC trauma score and the Quick DASH among patients, especially the elderly. It was noted that an elevation in the ICUC trauma score is linked to a more marked increase in the Quick DASH score, particularly in older patients. Given its simplicity and efficacy, the ICUC trauma score may be a viable alternative to the Quick DASH for assessing the patient's clinical outcomes.

Simple foot an ankle value: a simple evaluation correlated to the existing PROMs

PURPOSE

The SFAV (Simple Foot and Ankle Value) consists in asking patients how they rate their joint function on the day of the examination, as a percentage of that of a normal joint (0-100% scale with 100% being normal). The main objective was to validate the SFAV by determining its correlation with validated foot and ankle function scores.

METHODS

This was a prospective study. 90 patients were included in three groups: patients 16 to 54 years old with an acute or subacute ankle pathology (foot/ankle trauma patient group), patients more than 55 years old with ankle or foot osteoarthritis (foot/ankle degeneration patient group), and adults of any age without foot or ankle pathology (control group). A self-administered questionnaire with the American Orthopedic Foot and Ankle Society, The European Foot and Ankle Society, the Foot and Ankle Outcome Score, the Visual Analogic Scale, and the SFAV was given at three different timepoints (enrollment, preoperative visit, and 6-month postoperative visit) to the patients. The validity of the SFAV was investigated by determining its correlation with the existing foot and ankle PROMs using Spearman's correlation; test-retest reliability, the responsiveness to change, and the discriminative ability of the SFAV were also analyzed. The significance threshold was set at 0.05.

RESULTS

The SFAV was significantly correlated with the AOFAS, EFAS, and FAOS at all tested time points, with all p values below 0.033. SFAV scoring was reliable over time, as p values resulting from the comparison between initial and preoperative SFAV were all above the significance threshold. SFAV scoring was responsive to change, based on the comparison between pre- and postoperative SFAV (p < 0.05). Like for the AOFAS, EFAS, and FAOS, SFAV provides good discrimination between a healthy subject and a patient. The control group scores and initial consultation scores of the pooled patient's groups were statistically correlated (p < 0.05).

CONCLUSION

The SFAV is a valid outcome measure correlated with the AOFAS, EFAS, FAOS, and VAS.

LEVEL OF EVIDENCE

Level of evidence III.