Patient-Reported Outcome Measures in Hip Preservation Surgery: Are They All the Same?

Introduction: Historically, for hip procedures, the Hip Outcome Score (HOS) and the International Hip Outcome Tool 12 (iHOT-12) have been commonly usedas instruments for patient-reported outcome measures (PROMs). However, these tools are often influenced by other factors, such as concurrent illnesses, making more standardized tools a preferable choice. Patient-Reported Outcomes Measurement Information System-25 (PROMIS-25) is a standardized, validated PROMs metric that has correlated well with several other anatomy-specific PROMs tools. In this study, we aim to assess and compare the correlations between iHOT-12 and HOS with PROMIS-25 in adult and pediatric hip preservation patients.

Methods: This study included patients indicated for a hip preservation procedure at our institution. All patients completed the iHOT-12, HOS, and PROMIS instruments through an electronic PRO platform before surgery. Spearman correlations were calculated separately for adult and pediatric patients between the various domains in each tool. A rho-to-z transformation analysis was conducted to assess whether there are differences in PROMs correlations between demographic factors.

Results: A total of 62 patients were enrolled in this study from July 2020 to July 2023. The average age was 20.1 years (SD: 6.7 years), and more pediatric patients (64.5%) were enrolled than adult patients (35.4%). Multiple PROMIS domains, such as functional mobility, had strong or strong-moderate correlations with other hip PROMs in both adult (HOS activities of daily living: ρ = 0.76, P < 0.01; HOS Sports: ρ = 0.84, P < 0.01; iHOT-12: ρ = 0.85, P < 0.01) and pediatric (HOS activities of daily living: ρ = 0.79, P < 0.01; HOS Sports: ρ = 0.88, P < 0.01; iHOT-12: ρ = 0.66, P < 0.01) patients. Notable effects of age and sex were observed on correlations between PROMs (P< 0.05).

Conclusion: There are strong correlations between iHOT-12, HOS, and PROMIS domains designed to measure similar constructs in both age groups. However, certain demographic differences may markedly influence the correlation between iHOT-12/HOS and PROMIS. PROMIS-25 can accurately capture outcomes for both adult and pediatric patients undergoing hip preservation surgery.