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Pattern of impact of femoroacetabular impingement upon health-related quality of life: the determinant role of extra-articular factors.
PURPOSE: Despite the interest in surgical treatment of femoroacetabular impingement (FAI), its impact upon health-related quality of life (HRQoL) has not been established. The objectives of this study were twofold: (a) to describe the pattern of impact of FAI on HRQoL and (b) to assess how articular and extra-articular factors influence HRQoL in this group of patients.
METHODS: A total of 108 patients [55 females (50.9 %); age 36.0 ± 12.4 years] with intraoperatively confirmed FAI and no evidence of secondary hip osteoarthritis were studied. The pattern of impact on HRQoL was studied using SF-36 V.2™ and then contrasted with other medical conditions employing the SF-36 spydergram. The best model explaining the influence of "articular" and "extra-articular" factors over the SF-36 physical and mental component scores (PCS/MCS) was selected using the Akaike information criterion.
RESULTS: The PCS was 53.2 ± 19.2 and MCS was 68.94 ± 17.15. The SF-36 spydergram depicted an impact pattern distinguishable from other conditions. A linear model predicted PCS would increase by 8.9 points in male patients and 3.7 points per point of University of California Los Angeles score (p value <0.01; R2 0.29). For MCS, obesity resulted in a 12.7 point reduction, psychiatric comorbidity reduced it by 11.1; and a combined reduction of 19 points (p value <0.01; R2 0.18). Unexpectedly, the extent of intra-articular disease had no influence on PCS or MCS.
CONCLUSIONS: FAI impacts HRQoL with a distinguishable pattern. In our study, the manner in which HRQoL is affected by FAI can be explained only by patients' characteristics unrelated to the extent of intra-articular disease.
LEVEL OF EVIDENCE: Prognostic Level IV.
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