ARE ANXIETY AND DEPRESSION ASSOCIATED WITH A GREATER RISK OF NOT ACHIEVING A MEANINGFUL IMPROVEMENT IN PATIENT-REPORTED OUTCOME MEASURES AFTER HIP ARTHROSCOPY FOR FEMOROACETABULAR IMPINGEMENT?

Hip arthroscopy is recognised to offer therapeutic benefits for femoroacetabular impingement (FAI). There is growing evidence demonstrating an association between mental health and outcomes in hip arthroscopy. However, many studies have been single-centre, single-surgeon studies with limited numbers. The purpose of this study was to explore the relationship of patient reported anxiety and depression to outcomes for a large cohort of patients undergoing hip arthroscopy for FAI. Data were acquired from the UK Non-Arthroplasty Hip Registry dataset. Patients included were those over 18 years who had a primary arthroscopic intervention for FAI. Patient demographics, EQ-5D-5L scores, and iHOT-12 scores at pre-operative baseline and 1-year were recorded. EQ-5D question 5 (Q5) addresses anxiety/depression and was used as a surrogate marker for anxiety/depression. The iHOT-12 score was used to quantify outcomes of hip function. 5,109 patients between 2012–2024 were identified. 56% were female and average age was 35.3 (SD:10.1) years. Mean pre-operative iHOT-12 score was 33 (SD:18) and improved to 59 (SD:28) at 1-year with a mean change of 26 (range:-61–93). There was a significant negative correlation between pre-operative Q5 and both pre-operative iHOT-12 and iHOT-12 at 1-year. There was no significant correlation between change in iHOT-12 (ΔiHOT-12) at 1-year and pre-operative Q5. There was significant positive correlation between ΔiHOT-12 and ΔEQ-5D Q5 at 1-year. The number of patients achieving MCID was significantly lower (47% vs. population mean of 63%) in the group with the highest pre-op anxiety scores. Our findings showed that although there was a negative correlation between increased anxiety/depression and iHOT-12 outcomes this was not reflected in the relative improvement in outcomes. Those with greatest pre-operative anxiety/depression were at greater risk of not achieving MCID, however, they were most likely to see an improvement in their anxiety/depression scores. This study shows that although patients with increased anxiety/depression may achieve lower absolute outcomes they still benefit from relative improvement in outcomes and greater improvements in their anxiety/depression.