EP8.20 Earlier Treatment at a Younger Age May be a Key to Successful Hip Preservation: A Systematic Review

Abstract

Abstract Background Clinically relevant thresholds (CRTs), such as the Patient Acceptable Symptom State (PASS) and Substantial Clinical Benefit (SCB), are increasingly utilized to assess patient outcomes and manage patient expectations following hip arthroscopy. The purpose of this systematic review was to identify preoperative predictors of PASS and SCB achievement following primary hip arthroscopy, with a secondary analysis evaluating studies using modern versus non-modern surgical techniques. Study Design Level IV – Systematic Review of Level II, III, IV studies Methods A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The PubMed, Embase, and Scopus databases were searched to identify studies that reported predictors of PASS and/or SCB achievement after primary hip arthroscopy. Included studies were required to conduct a logistic regression analysis to identify statistically significant outcome predictors. Studies evaluating modern techniques included those with rates of capsular repair and labral repair/reconstruction in at least 80% of cases. Results 19 studies were included, evaluating 6,315 patients and 6,380 hips. 8 studies reported using modern surgical techniques (MT). Included studies evaluated predictors for a total of 27 PASS and 13 SCB thresholds across 11 PROs, with follow-up timepoints ranging from 1 to 10 years postoperatively. CRTs were most commonly assessed for the mHHS and iHOT-33 in 8 and 6 studies, respectively. Shorter symptom duration was the most common predictor in MT studies (significant in 8 of 9 thresholds for which it was evaluated) and younger age being the most common in NMT studies (significant in 7 of 15 thresholds). Conclusion This review found that shorter preoperative symptom duration and younger age were common predictors of SCB and PASS achievement following primary hip arthroscopy with modern and non-modern techniques. These findings highlight the importance of early clinical diagnosis and surgical intervention in optimizing patient outcomes and clinical improvement.