Note: To access the video accompanying this report, visit the February issue of Arthroscopy at www.arthroscopyjournal.org.
Arthroscopy: The Journal of Arthroscopic & Related Surgery
Systematic Review with Video IllustrationPatient-Reported Outcome Instruments for Femoroacetabular Impingement and Hip Labral Pathology: A Systematic Review of the Clinimetric Evidence
Section snippets
Literature Search
Two computerized literature searches were conducted in consultation with a medical librarian. The purpose of the first search was to identify the PRO instruments used in the assessment of subjects with FAI or hip labral pathology. We combined Medical Subject Heading and title words related to FAI and labrum/labral tears. There were no language restrictions. We searched for articles published from 1966 to November 2008. The Ovid interface was used to search the following databases: Medline,
Results
The first literature search identified 1,147 titles potentially relevant to FAI or hip labral pathology. Of these, 22 articles fit the inclusion criteria and were analyzed to find the different PRO instruments used. We identified the following 6 hip-related PRO instruments:
- 1
Harris Hip Score (HHS)
- 2
Modified HHS
- 3
Merle d'Aubigne Hip Score
- 4
Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index
- 5
Non-Arthritic Hip Score (NAHS)
- 6
Hip Outcome Score (HOS)
A second literature search for clinimetric
Discussion
This study provides a comprehensive evaluation of the clinimetric properties of PRO instruments used in patients with FAI and labral pathology. We have identified 3 PRO instruments that have undergone clinimetric analysis for use in femoroacetabular and labral pathology subjects. None of the questionnaires showed positive ratings in all 9 categories; however, the HOS clearly had the most data describing its properties. Furthermore, several instruments used in the FAI and labral pathology
Conclusions
Only 3 PRO instruments have shown clinimetric evidence to support their use to measure outcomes in patients with FAI and labral pathology. The HOS has the greatest amount of clinimetric evidence and thus far is the most proven instrument for use in this population. This review shows that further clinimetric evaluation of commonly used PRO instruments for nonarthritic hip pathology is warranted. Additional studies of these instruments include language translations, respondent and administrative
Acknowledgment
The authors thank Dean Guistini, Reference Librarian, Biomedical Branch Library, University of British Columbia, for his help with the literature searches.
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The authors report no conflict of interest.