Patient-Reported Outcome Measures in Hip Preservation Surgery: Are They All the Same?

Luke Sang; Kian Niknam; Ishaan Swarup

doi:10.5435/JAAOS-D-24-00150

Patient-Reported Outcome Measures in Hip Preservation Surgery: Are They All the Same?

J Am Acad Orthop Surg. 2024 Dec 4. doi: 10.5435/JAAOS-D-24-00150. Online ahead of print.

Authors

Luke Sang¹, Kian Niknam, Ishaan Swarup

Affiliation

¹ From the School of Medicine (Sang and Niknam), University of California, San Francisco, San Francisco, CA, and the Department of Orthopedic Surgery (Swarup), University of California, San Francisco, San Francisco, CA.

PMID: 39657169
DOI: 10.5435/JAAOS-D-24-00150

Abstract

Introduction: Historically, for hip procedures, the Hip Outcome Score (HOS) and the International Hip Outcome Tool 12 (iHOT-12) have been commonly usedas instruments for patient-reported outcome measures (PROMs). However, these tools are often influenced by other factors, such as concurrent illnesses, making more standardized tools a preferable choice. Patient-Reported Outcomes Measurement Information System-25 (PROMIS-25) is a standardized, validated PROMs metric that has correlated well with several other anatomy-specific PROMs tools. In this study, we aim to assess and compare the correlations between iHOT-12 and HOS with PROMIS-25 in adult and pediatric hip preservation patients.

Methods: This study included patients indicated for a hip preservation procedure at our institution. All patients completed the iHOT-12, HOS, and PROMIS instruments through an electronic PRO platform before surgery. Spearman correlations were calculated separately for adult and pediatric patients between the various domains in each tool. A rho-to-z transformation analysis was conducted to assess whether there are differences in PROMs correlations between demographic factors.

Results: A total of 62 patients were enrolled in this study from July 2020 to July 2023. The average age was 20.1 years (SD: 6.7 years), and more pediatric patients (64.5%) were enrolled than adult patients (35.4%). Multiple PROMIS domains, such as functional mobility, had strong or strong-moderate correlations with other hip PROMs in both adult (HOS activities of daily living: ρ = 0.76, P < 0.01; HOS Sports: ρ = 0.84, P < 0.01; iHOT-12: ρ = 0.85, P < 0.01) and pediatric (HOS activities of daily living: ρ = 0.79, P < 0.01; HOS Sports: ρ = 0.88, P < 0.01; iHOT-12: ρ = 0.66, P < 0.01) patients. Notable effects of age and sex were observed on correlations between PROMs (P< 0.05).

Conclusion: There are strong correlations between iHOT-12, HOS, and PROMIS domains designed to measure similar constructs in both age groups. However, certain demographic differences may markedly influence the correlation between iHOT-12/HOS and PROMIS. PROMIS-25 can accurately capture outcomes for both adult and pediatric patients undergoing hip preservation surgery.