EP1.79 How Does the Achievement of Minimal Clinically Important Difference, Substantial Clinical Benefit, and Patient-Acceptable Symptom State Change Over Time Following Periacetabular Osteotomy?

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ID: 331266
2026
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Abstract
Abstract Introduction Anchor-based values for minimal clinically important difference (MCID), substantial clinical benefit (SCB), and patient acceptable symptom state (PASS) were recently defined for the modified Harris hip score (mHHS) and International Hip Outcome Tool-12 (iHOT-12) among patients undergoing periacetabular osteotomy (PAO). Prior studies have assessed outcomes of PAO relative to smaller thresholds derived from hip arthroscopy, potentially overestimating rates of clinical achievement. Therefore, this study aimed to determine the probability of achieving MCID, SCB, and PASS using threshold values that accurately characterize PAO patient perception; and identify factors associated with time to achieving clinically significant outcomes. Methods This retrospective review of prospectively collected data included 608 patients (93% female, mean age at time of surgery 26 ± 8 years) undergoing PAO between 2011 and 2024 with minimum 1-year follow-up. Cumulative probabilities of achieving MCID, SCB, and PASS were determined using the Turnbull estimator and interval-censoring. Weibull regression models were used to identify variables associated with the time to achieving each outcome. Results For the mHHS, cumulative probabilities of achieving clinically significant outcomes at 1, 2, 5, and 10 years were: MCID 61%, 68%, 81%, 91%; SCB 54%, 60%, 74%, 88%; PASS 78%, 86%, 92%, 95%. For the iHOT-12, corresponding probabilities were: MCID 69%, 78%, 86%, 95%; SCB 52%, 64%, 76%, 83%; PASS 66%, 75%, 84%, 97%. Prior ipsilateral hip surgery, bilateral surgery, a psychological comorbidity, and older age at time of surgery were associated with a longer time to achieve clinically significant outcomes. Conclusion At the 1-year timepoint, the probabilities of achieving a clinically significant outcome were lower than previously reported rates, suggesting prior research may have minimized the magnitude of PAO recovery. However, patients can be counseled that pain and functional gains continue at subsequent timepoints through 10-years postoperatively. These results provide a foundation for setting realistic patient expectations regarding timeframes for postoperative improvement, particularly among patients demonstrating risk factors associated with a longer time to clinical achievement.
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Authors Zachary Trotzky, Cassidy Owens, Sophie Rosa Merckaert, Olivia Jochl, Ernest L. Sink
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.263
URL
https://doi.org/10.1093/jhps/hnag043.263
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