PL3.7 The Role of Mental Health in the Presentation and Outcomes of Femoroacetabular Impingement Surgery: A prospective multicenter study
Bibliographic record
Abstract
Abstract Background Mental health disorders, particularly anxiety and depression, are frequently observed in patients with hip disorders, including femoroacetabular impingement (FAI). The impact of these conditions on clinical presentation and postoperative outcomes remains unclear. This study aimed to 1) assess the rates of anxiety and depression in patients presenting with symptomatic FAI and 2) evaluate differences in patient-reported outcomes (PROs) between those with and without significant anxiety or depression symptoms. Methods This multicenter, prospective study involved 677 hips undergoing primary hip arthroscopy for FAI across 13 surgeons at 16 institutions from 2020 to 2022. Patients with prior ipsilateral surgeries, acetabular dysplasia (LCEA<20 degrees), or associated diagnoses (SCFE, Perthes) were excluded. Baseline and one-year follow-up included assessment of PROs, including PROMIS anxiety and depression. Clinically significant mental health symptoms were defined according to established thresholds for anxiety (PROMIS anxiety ≥62) and depression (PROMIS depression ≥60). Results 551 hips (81.3%) were successfully followed at a minimum 1-year timepoint. The mean age was 24.8±7.9 years with 54.1% female. At one-year follow-up, mental health PROs improved from 51.7±10.2 to 47.9±11.3 for PROMIS Anxiety (p<0.001) and from 48.3±9.6 to 45.7±9.8 for PROMIS Depression (p<0.001). Rates of significant anxiety decreased postoperatively from 17.0% to 11.5%, significant depression decreased from 11.9% to 8.8%, and having either anxiety or depression decreased from 20.7% to 14.5%. Patients with significant baseline depression symptoms had inferior postoperative outcomes than those without, including lower mHHS (80.6±15.1 vs. 87.4±13.7, p<0.001) and lower iHOT-12 (62.6±27.8 vs. 76.7±23.3, p<0.001). Patients with significant baseline anxiety symptoms had inferior outcomes than those without, including lower mHHS (81.3±15.8 vs. 87.7±13.3, p<0.001) and lower iHOT-12 (62.8±28.1 vs. 77.7±22.6, p<0.001). Similarly, patients with significant baseline depression or anxiety symptoms had lower achievement rates for Minimal Clinically Important Difference (MCID) (depression:75% vs. 88%; anxiety:79% vs. 88%) and higher composite failure rates (depression:21% vs. 8%; anxiety:18% vs. 8%). Conclusion We highlighted the prevalence of anxiety and depression in patients undergoing hip arthroscopy for FAI and their association with inferior postoperative outcomes. These findings underscore the importance of preoperative mental health assessments and potential interventions to improve surgical outcomes in patients with FAI.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".