CHANGES IN SOCIAL AND EMOTIONAL HEALTH FOLLOWING HIP PRESERVATION SURGERY: A NON-ARTHROPLASTY HIP REGISTRY STUDY

Pain and musculoskeletal conditions can have important consequences on the mental health of patients living with them. Hip pathology in young adult patients can be particularly troubling, as it can impact a range of important domains in a patient's life, including physical activity participation and sexual activity. Hip preservation surgery to treat conditions such as femoroacetabular impingement and acetabular dysplasia improve function and return patients to their physical activities. It is important to understand if there is a concordant improvement in mental health among these patients. Thus, the purpose of this study was to evaluate anxiety and depression scores before and after hip preservation surgery (hip arthroscopy and periacetabular osteotomy (PAO)). The Non-Arthroplasty Hip Registry (NAHR) collects data on patients undergoing hip preservation surgery across the United Kingdom. Patients in the registry who had undergone hip arthroscopy or PAO were included in this study. The EuroQol-5-Dimensions (EQ-5D), and the International Hip Outcome Tool (iHOT-12) are routinely collected as part of the NAHR data collection. Paired samples analyses were performed to evaluate the change from baseline to 1-year post-operative. Sensitivity analyses included separate analysis of hip arthroscopy and PAO, and separate analysis of male and female patients. A total of 8408 patients were included, of whom 1327 underwent PAO and 7081 underwent hip arthroscopy. Mean age among the included patients was 35.4 (standard deviation: 11.1). The mean score on the Social/Emotional Domain of the International Hip Outcome Tool (iHOT-12) improved significantly from 32.8 at baseline to 42.7 at 6 weeks (p < 0.001), and 57.3 at 6 months. These improvements were maintained at one year (58.5). Based on the EQ-5D, the proportion of patients who stated they were “not anxious or depressed” at baseline was 41.6%, which increased significantly to 55.7% at six months (p < 0.001), and remained at 55.3% at one year. The findings were similar between when patients undergoing hip arthroscopy and PAO were analyzed separately, and when male and female patients were analyzed separately. Patients undergoing hip preservation surgery demonstrate measurable improvements in their mental health, including significant improvements in anxiety and depression scores at six months post hip preservation surgery, and these improvements are maintained at one year. In addition to functional improvements demonstrated in previous literature, hip preservation surgery is associated with a substantial improvement in social and emotional health. Future studies should evaluate the long-term mental and social health of patients undergoing hip preservation surgery.

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