EP8.18 Preoperative Pain-Associated Psychological Distress (OSPRO-YF) is Associated with Worse PROMIS Outcomes After Hip Arthroscopy and Periacetabular Osteotomy

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ID: 331199
2026
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Abstract
Abstract Background Preoperative psychological risk assessment is important for managing expectations and guiding targeted interventions for patients with hip pain. Two tools, the Optimal Screening for Prediction of Referral and Outcome-Yellow Flag (OSPRO-YF) survey (which evaluates key psychological constructs) and the Patient-Reported Outcomes Measure Information System (PROMIS) (which assesses pain interference, physical function, and depression) are key instruments in accomplishing this assessment. This study aimed to examine the relationship between pre-operative OSPRO-YF scores and changes in PROMIS outcomes following hip arthroscopy and/or periacetabular osteotomy (PAO). Methods Data were acquired from electronic medical records within a tertiary academic center. Patients were included if they: (1) underwent hip arthroscopy, PAO, or both, between January 2020 and May 2025, (2) were 18-45 years old, (3) completed the OSPRO-YF preoperatively, and (4) completed the PROMIS-PI, PROMIS-PF, and PROMIS-Depression surveys preoperatively and at 1 year postoperatively. The preoperative OSPRO-YF survey closest to surgery was used to determine total yellow flags. Spearman’s rank-order correlation was used to assess correlation between number of OSPRO yellow flags and changes in PROMIS scores. Results A total of 298 patients met inclusion criteria with a mean age of 30.8 ± 7.8 years; 73.8% were women. The median number (interquartile range) of yellow flags was 7.0 (3.0-9.0). In our cohort, 44 patients (14.8%) reported 11 yellow flags. The highest frequency of yellow flags was found in the fear avoidance domain (84.9%). Higher preoperative OSPRO-YF scores were associated with worse PROMIS pain interference (ρ = 0.24; p < 0.001), physical function (ρ = -0.15; p < 0.009), and depression scores (ρ = 0.27, p < 0.001). Conclusion Our study shows that there is a high prevalence of pain-associated psychological distress in patients with hip pain. Furthermore, having a greater number of psychological yellow flags pre-surgery was correlated with greater self-assessed pain interference, more severe impairment of physical functioning, and greater depression severity. Patients with higher PROMIS scores would likely benefit from preoperative evaluation, counseling, and postoperative rehabilitation regimens that target psychological distress in addition to biomedical pathology.
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Authors Akash Desai, Morgan Pierce, Grant H. Cabell, Richard C. “Chad” Mather, Steven A. Olson, Brian D. Lewis, Amy Behman
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.399
URL
https://doi.org/10.1093/jhps/hnag043.399
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