Background:In patients with femoroacetabular impingement (FAI), mental health has been implicated in both symptom severity and postoperative outcomes. However, there are limited data regarding the independent influences of baseline mental health and hip pathology on patient-reported outcomes over time after hip arthroscopy.Purpose:To evaluate the association between mental health and structural hip pathology with pain, hip function, and quality of life (QOL).Study Design:Cohort study; Level of evidence, 3.Methods:Patient records from a single surgeon’s hip outcomes registry were retrospectively reviewed. Mental health was evaluated using the Patient-Reported Outcomes Measurement Information System Anxiety and Depression scores. Pain was evaluated with the Single Assessment Numeric Evaluation score for Activities of Daily Living (SANE-ADL), while hip-related QOL was evaluated with the 12-item International Hip Outcome Tool (iHOT-12). Hip function was assessed with the Hip Outcome Score (HOS) Sport-Specific (SS) and ADL subscales. Separate mixed models were used to predict pain, QOL, and hip function, including hip pathology measures (size of labral tear, grade of chondral damage, preoperative alpha angle), anxiety, depression, and time as fixed effects and individuals as a random effect.Results:A total of 312 patients were included in this study. The preoperative alpha angle, degree of intraoperative cartilage damage, and size of the labral tear were not associated with pain or QOL ( P > .05 for all). However, higher levels of anxiety and depression were significantly associated with lower SANE-ADL scores (estimate ± SE) (anxiety: –0.59 ± 0.07, P < .0001; depression: –0.64 ± 0.08, P < .0001), iHOT-12 scores (anxiety: –0.72 ± 0.07, P < .0001; depression: –0.72 ± 0.08, P < .0001), HOS-SS scores (anxiety: –0.68 ± 0.09, P < .0001; depression: –0.57 ± 0.10, P < .0001), and HOS-ADL scores (anxiety: –0.43 ± 0.05, P < .0001; depression: –0.43 ± 0.06, P < .0001).Conclusion:Patients had similar improvements in pain scores, QOL, and hip function after hip arthroscopy for FAI irrespective of their degree of hip pathology. Additionally, preoperative symptoms of anxiety and depression symptoms were associated with greater pain, decreased QOL, and worse hip function both pre- and postoperatively, independent of the degree of hip pathology. This suggests that efforts to directly address symptoms of anxiety and depression may improve outcomes after hip arthroscopy.

中文翻译：

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股骨髋臼撞击症髋关节镜检查后焦虑和抑郁症状、髋关节病理学和患者报告结果之间的关联


背景：在股骨髋臼撞击（FAI）患者中，心理健康与症状严重程度和术后结果有关。然而，关于基线心理健康和髋关节病理学对髋关节镜检查后随时间推移患者报告的结果的独立影响的数据有限。目的：评估心理健康和结构性髋关节病理学与疼痛、髋关节功能和手术质量之间的关联。研究设计：队列研究；证据级别，3。方法：对单个外科医生髋关节结果登记处的患者记录进行回顾性审查。使用患者报告的结果测量信息系统焦虑和抑郁评分来评估心理健康状况。使用日常生活活动单一评估数字评估评分 (SANE-ADL) 评估疼痛，​​使用 12 项国际髋关节结果工具 (iHOT-12) 评估髋关节相关的生活质量。髋关节功能通过髋关节结果评分 (HOS) 运动特定 (SS) 和 ADL 子量表进行评估。使用单独的混合模型来预测疼痛、生活质量和髋关节功能，包括髋关节病理学测量（盂唇撕裂的大小、软骨损伤的程度、术前 α 角）、焦虑、抑郁和时间（作为固定效应）和个体（作为随机效应）结果：本研究共纳入312例患者。术前α角、术中软骨损伤程度和盂唇撕裂大小与疼痛或生活质量无关（均P > 0.05）。然而，较高水平的焦虑和抑郁与较低 SANE-ADL 评分显着相关（估计值 ± SE）（焦虑：–0.59 ± 0.07，P < .0001；抑郁：–0.64 ± 0.08，P < .0001），iHOT- 12 分（焦虑：–0.72 ± 0.07，P < .0001；抑郁：–0.72 ± 0。08，P < .0001)、HOS-SS 评分（焦虑：–0.68 ± 0.09，P < .0001；抑郁：–0.57 ± 0.10，P < .0001）和 HOS-ADL 评分（焦虑：–0.43 ± 0.05 ，P < .0001；抑郁症：–0.43 ± 0.06，P < .0001）。结论：FAI 髋关节镜检查后，无论患者的髋关节病理程度如何，患者的疼痛评分、生活质量和髋关节功能都有相似的改善。此外，术前焦虑和抑郁症状与术前和术后疼痛加剧、生活质量下降和髋关节功能较差相关，与髋关节病理程度无关。这表明直接解决焦虑和抑郁症状的努力可能会改善髋关节镜手术后的结果。