EP8.66 Patient-Reported Outcomes and Predictors of Response Following Psoas Release: A Study from the UK Non-Arthroplasty Hip Registry

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ID: 331116
2026
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Abstract
Abstract Background Iliopsoas pathology is an increasingly recognised cause of groin pain in the hip preservation population, and psoas release is performed with growing frequency as both a primary and a concomitant procedure. Despite this, large-scale outcome data remain scarce and predictors of response are poorly defined. Using prospectively collected data from the Non-Arthroplasty Hip Registry (NAHR), we aimed to evaluate patient-reported outcomes following psoas release and to identify predictors of outcome. Methods We performed a retrospective cohort study of all patients undergoing psoas release recorded in the NAHR between April 2013 and January 2026. Patient-reported outcomes [the International Hip Outcome Tool (iHOT), EuroQol 5-Dimension Index (EQ-5D) and EQ-5D Visual Analogue Scale (EQ-5D VAS)] were collected at baseline, 6, 12 and 24 months. Change over time was modelled using linear mixed-effects regression with random intercepts. Linear regression identified predictors of iHOT and EQ-5D scores at 6 and 12 months, adjusting for pre-operative score, age, sex, BMI, funding source, concomitant labral repair and cam removal. Association between characteristics and achievement of the Minimal Clinically Important Difference (MCID) score improvement at 12 months (derived as 0.5 standard-deviation of baseline score) were assessed using binary logistic regression. Results A total of 605 patients were included (mean age 36.7 years; 77% female; mean BMI 25.6 kg/m2); 98% of procedures were arthroscopic and 65% were NHS-funded. Significant improvements were observed across all outcomes. Mean iHOT rose from 29.6 ± 18.2 pre-operatively to 60.2 ± 28.1 at 6 months and was maintained at 12 months (59.3 ± 28.0). EQ-5D Index improved from 0.470 ± 0.247 to 0.664 ± 0.243 at 6 months (0.664 ± 0.231 at 12 months); EQ-5D VAS improved from 64.3 ± 22.8 to 72.9 ± 20.9. Time was a significant predictor across all outcomes (p<0.001). At 12 months, 65.1% of patients achieved the MCID for iHOT and 53.6% for EQ-5D. Pre-operative score was the strongest and most consistent predictor of both continuous outcomes and achievement of MCID. Concomitant labral repair was associated with higher iHOT at 12 months (β = +11.3, p = 0.022). NHS funding was associated with lower iHOT at 6 months (β = −25.1, p = 0.012), with no significant difference at 12 months. Conclusion In this large registry-based cohort, psoas release produced statistically and clinically meaningful improvements in patient-reported outcomes. Lower pre-operative scores were the strongest predictor of meaningful response, suggesting that patients with greater pre-operative burden derive the most benefit. The association of concomitant labral repair with superior hip-specific outcomes highlights the importance of addressing coexisting intra-articular pathology when planning surgery.
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Authors Yash Pursun, Richard Holleyman, Tim Board, Marcus Bankes, Non-Arthroplasty Hip Registry Non-Arthroplasty Hip Registry, Vikas Khanduja, Ajay Malviya
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.445
URL
https://doi.org/10.1093/jhps/hnag043.445
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