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Abstract
Many young individuals undergoing hip arthroscopic surgery have hip chondropathy. The impact of mild or more severe hip chondropathy 1–2 years following arthroscopy is poorly understood. The purpose of this study was to (i) compare health-related quality of life (HRQoL), anxiety and depression scores between people who underwent arthroscopic treatment for hip chondropathy 1–2 years previously and pain-free controls; (ii) compare HRQoL, hip-related quality of life (QoL) and anxiety/depression scores in people with mild versus severe hip chondropathy and (iii) compare hip-related QoL items between chondropathy groups. The Hip disability and Osteoarthritis Outcome Score (HOOS), International Hip Outcome Tool (iHOT-33), EuroQol-5D and Hospital Anxiety and Depression Scale (HADS) were compared between 71 individuals aged 18–60 years following arthroscopic treatment for hip chondroplasty (12–24 months previously) and 46 healthy controls. Comparisons were also performed between people with mild (Outerbridge grade 1–2) and severe (Outerbridge grade 3–4) hip chondropathy. Participants following arthroscopic treatment for hip chondroplasty reported worse HRQoL, hip-related QoL and anxiety, compared with pain-free controls (all P < 0.05), but no difference in self-care (P = 0.20). There were differences between mild and severe chondropathy groups for pain during sport/recreation [median (IQR) 20 (5–80) versus 60 (25–90) P = 0.01), pain after activity (40 (20–75) versus 75 (50–90) P = 0.01), difficulty maintaining fitness (30 (10–70) versus 75 (35–85) P = 0.02) and reduced hip confidence. Hip chondropathy was associated with significant QoL impairment, with severe chondropathy associated with the greatest impairment. The identification of specific areas of QoL impairment provides avenues to target rehabilitation and support.
Highlights
Osteoarthritis (OA) frequently affects the hip joint and is a major global public health problem with substantial psychological, physical, societal and economic impacts [1]
Data were incomplete for one participant and data from 71 participants following arthroscopic treatment for hip chondroplasty were available for analysis
Chondropathy patients were evaluated at an average of 17 months postsurgery and had a slightly higher BMI [median (IQR) hip chondropathy 25 (23–28); control 23 (21–26), P 1⁄4 0.01], compared to the control group
Summary
Osteoarthritis (OA) frequently affects the hip joint and is a major global public health problem with substantial psychological, physical, societal and economic impacts [1]. Young and middle aged adults may be living with hip pain related to intra-articular pathology for some years before being diagnosed with hip OA. Hip arthroscopy is commonly performed to diagnose and treat severe and restrictive hip pain, and rates of surgery are rapidly rising. In the United States, arthroscopy rates increased by 365% over 5 years (2004–2009), with the majority of surgeries performed in young adults aged 20–39 years [6]. The impact of this dramatic rise is compounded by the high proportion of hip arthroscopy patients (37%) who will undergo a total hip arthroplasty within 10 years following surgery [7].
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