Higher preoperative patient expectations predict better patient-reported psychosocial health outcomes after hip arthroscopy

Leah E Henry; Brandon Leon; Dominic J Ventimiglia; Michael A McCurdy; Stefan Dabic; Natalie L Leong; Jonathan D Packer; R Frank Henn 3rd; Sean J Meredith

doi:10.1016/j.jor.2024.11.010

Higher preoperative patient expectations predict better patient-reported psychosocial health outcomes after hip arthroscopy

J Orthop. 2024 Nov 19:64:23-28. doi: 10.1016/j.jor.2024.11.010. eCollection 2025 Jun.

Authors

Leah E Henry¹, Brandon Leon¹, Dominic J Ventimiglia¹, Michael A McCurdy¹, Stefan Dabic¹, Natalie L Leong¹, Jonathan D Packer¹, R Frank Henn 3rd¹, Sean J Meredith¹

Affiliation

¹ Department of Orthopaedic Surgery, University of Maryland School of Medicine, Baltimore, MD, USA.

PMID: 39654639
PMCID: PMC11625337 (available on 2026-06-01)
DOI: 10.1016/j.jor.2024.11.010

Abstract

Introduction: Preoperative expectations are a determinant of patient-reported outcomes (PROs) within several orthopaedic subspecialties. However, the impact on outcomes after hip arthroscopy is unclear. The aim of this study was to explore the relationship between preoperative patient expectations and PROs after hip arthroscopy.

Methods: Patients who underwent hip arthroscopy at a single institution were included. Patient expectations were measured preoperatively using the Musculoskeletal Outcomes Data Evaluation and Management System (MODEMS) expectations domain. Patient-Reported Outcomes Measurement Information System (PROMIS) domains, a numeric pain scale (NPS), and the Marx activity rating scale (MARS) were assessed 2 years postoperatively. Spearman's coefficient was used to assess the correlation between preoperative expectations and 2-year PROs. Linear regression was used to ascertain the effect of preoperative expectations on 2-year PROs.

Results: 105 patients were included, and 78 (74 %) completed 2-year follow-up. The mean (SD) preoperative expectations score was 88.3 (15.3). Higher expectations correlated with better postoperative fatigue, anxiety, depression, pain, and activity levels, as well as more improvement in fatigue, pain, and activity. Expectations scores were higher for patients who achieved minimal clinically important difference (MCID) for PROMIS Fatigue (92.6 vs 82.0, p = .003) and MARS activity (95.3 vs 86.2, p = .014). When controlling for possible confounders, higher expectations independently predicted better postoperative PROMIS Fatigue (β = -0.26, SE = 7.23), Social Satisfaction (β = 0.24, SE = 0.09), and Anxiety (β = -0.24, SE = 0.08).

Conclusion: Higher preoperative expectations are an independent predictor of better psychosocial outcomes 2 years after hip arthroscopy. Setting positive expectations preoperatively may be important for enhancing psychosocial health postoperatively.

Keywords: Hip arthroscopy; MODEMS; PROMIS; Psychosocial outcomes; preoperative expectations.