Minimal Clinically Important Difference (MCID), Substantial Clinical Benefit (SCB), and Patient Acceptable Symptom State (PASS) Values Following Hip Arthroscopy for Femoroacetabular Impingement Are Highly Dependent on Their Study Population and Calculation Methods: A Systematic Review

Abstract

PurposeTo provide a summary of available literature on the Minimal Clinically Important Difference (MCID), Substantial Clinical Benefit (SCB), and Patient Acceptable Symptom State (PASS) after hip arthroscopy for femoroacetabular impingement (FAI). MethodsA systematic review was conducted via the Cochrane Library, Pubmed, Ovid MEDLINE, and Embase to identify studies that calculated MCID, SCB, or PASS for Patient Reported Outcome Measures PROMs after hip arthroscopy for FAI. The electronic search strategy used was as follows: hip AND arthroscopy AND (MCID OR "minimal clinically important difference" OR SCB OR "substantial clinical benefit" OR PASS OR "patient acceptable symptom state"). Inclusion criteria were English language studies published from 1980 to 2023 reporting clinical outcome scores and calculated values of MCID, PASS, or SCB for patients undergoing hip arthroscopy for FAI. ResultsForty-two studies (5 level II, 19 level III, and 18 level IV) met inclusion and exclusion criteria. The most commonly used outcome measures across MCID, SCB, and PASS were the Hip Outcome Score sports-specific subscale (HOS-SSS) and the activities of daily living subscale (HOS-ADL), the modified Harris Hip Score (mHHS), and the twelve-item international Hip Outcome Tool (iHOT-12). The range of MCID values for HOS-SSS, HOS-ADL, mHHS, and iHOT-12 were 7.2-15.7, 7.3-15.4, 7.2-16.8, and 8.8-16.2 respectively. Similarly, for SCB the values ranged from 77.9-96.9, 90.4-98.5, 20.0-98.4, and 66.7-87.5, respectively. Lastly, the PASS values ranged from 63.9-80.9, 85.9-99.2, 74.0-97.0, and 59.5-86.0, respectively. ConclusionMCID, SCB, and PASS values for PROMs following hip arthroscopy for the management of FAI are highly dependent on their associated study including study population and calculation methods. Level of EvidenceIV, systematic review of Level II-IV studies.