Preoperative Psychosocial Factors and Short-term Pain and Functional Recovery After Hip Arthroscopy for Femoroacetabular Impingement Syndrome

Kate N. Jochimsen, Brian Noehren, Carl G. Mattacola, Stephanie Di Stasi, Stephen T. Duncan, Cale Jacobs

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Context: Low mental health scores, depression, and anxiety are associated with worse pain and functional outcomes after hip arthroscopy for patients with femoroacetabular impingement syndrome (FAIS). Preoperative screening of psychosocial factors such as self-efficacy, kinesiophobia, and pain catastrophizing may further aid in identifying patients at risk for poorer outcomes. Objective: To compare preoperative function and psychosocial factors between patients with and those without elevated postoperative pain 3 months after hip arthroscopy for FAIS. Design: Prospective cohort study. Setting: University health center. Patients or Other Participants: Fifty-one individuals with FAIS (41 women, 10 men; age = 37.6 ± 12.3 years, body mass index = 27.1 ± 4.1 kg/m2). Main Outcome Measure(s): Preoperatively, participants completed the Pain Self-Efficacy Questionnaire (PSEQ), Tampa Scale for Kinesiophobia (TSK), Pain Catastrophizing Scale (PCS), 12-Item International Hip Outcome Tool (iHOT-12), and a 10-point visual analog scale (VAS) for hip pain at rest and during activity. Three months postoperatively, they completed the PSEQ, TSK, PCS, iHOT-12, and VAS. Preoperative scores were compared between those with (VAS ≥ 3) and those without (VAS, 3) elevated postoperative pain using Mann-Whitney U tests, and odds ratios were calculated to determine the odds of having elevated postoperative pain and lower postoperative function. Results: Participants with elevated postoperative pain at rest and during activity had worse preoperative psychosocial health (P ≤.04). Those with elevated postoperative pain at rest had worse preoperative function (P,.001). The odds of having elevated postoperative pain at rest were 45 times and 4.5 times higher for those with low self-efficacy and high pain catastrophizing, respectively (P values ≤.03). The odds of having elevated postoperative pain during activity were 7.1, 6.2, and 3.5 times higher for those with low self-efficacy, high kinesiophobia, and high pain catastrophizing, respectively (P values ≤.04). The odds of having lower postoperative iHOT-12 scores were 7.5 and 14.0 times higher for those with high kinesiophobia and pain catastrophizing, respectively (P values ≤.03). Conclusions: Poor preoperative psychosocial health increased the odds of elevated pain and worse function 3 months after hip arthroscopy for FAIS. This is a first step in identifying the psychosocial factors that may contribute to poorer long-term hip arthroscopy outcomes.

Original languageEnglish
Pages (from-to)1064-1071
Number of pages8
JournalJournal of Athletic Training
Volume56
Issue number10
DOIs
StatePublished - Oct 2021

Bibliographical note

Funding Information:
Stephanie Di Stasi, PhD, PT, reports being an Associate Editor for the Journal of Orthopaedic & Sports Physical Therapy and grants from the National Institute of Arthritis and Musculoskeletal and Skin Diseases and the Foundation for Physical Therapy Research. Stephen T. Duncan, MD, reports grants and personal fees from Smith + Nephew, grants and personal fees from Zimmer Biomet, grants from Stryker Corp, and grants from BoneSupport AB. Cale Jacobs, PhD, ATC, reports grants from Medtronic, grants from Smith + Nephew, and grants and personal fees from Flexion Therapeutics.

Funding Information:
Stephanie Di Stasi, PhD, PT, reports being an Associate Editor for the Journal of Orthopaedic & Sports Physical Therapy and grants from the National Institute of Arthritis and Musculoskeletal and Skin Diseases and the Foundation for Physical Therapy Research. Stephen T. Duncan, MD, reports grants and personal fees from Smith + Nephew, grants and personal fees from Zimmer Biomet, grants from Stryker Corp, and grants from BoneSupport AB. Cale Jacobs, PhD, ATC, reports grants from Medtronic, grants from Smith þ Nephew, and grants and personal fees from Flexion Therapeutics.

Publisher Copyright:
© by the National Athletic Trainers' Association, Inc

Keywords

  • hip function
  • kinesiophobia
  • pain catastrophizing

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

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