TP8.4 Higher Resilience Is Associated with Superior Early Postoperative Outcomes Following Hip Preservation Surgery: Analysis of a Prospective Cohort

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ID: 331358
2026
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Abstract
Abstract Background Resilience has emerged as a potentially modifiable determinant of surgical recovery, yet its relationship to functional outcomes following hip preservation surgery (HPS) remains incompletely defined. This study investigates whether resilience predicts outcomes in patients undergoing HPS, using the Brief Resilience Scale (BRS) to quantify patients’ ability to handle negative events. Methods 65 patients undergoing hip preservation surgery (isolated arthroscopy [Group A, n=52] or arthroscopy plus PAO [Group B, n=13]) were prospectively enrolled. BRS total scores were collected at 6 and 12 months postoperatively and used to stratify patients into tertiles; low (≤33rd percentile), normal (33rd–67th percentile), and high resilience (>67th percentile). Primary outcomes included the Modified Harris Hip Score (MHHS), PROMIS Global Mental Health, and PROMIS Global Physical Health. Complications including emergency department (ED) visits, hospital readmission, and reoperation were recorded. Results The cohort was predominantly female (76.9%), with a mean age of 30.2 ± 9.0 years (range 18–53) and mean BMI of 27.6 ± 6.3. At 6 months (n=53; Low n=19, Normal n=25, High n=9; Group A: n=45, Group B: n=8), higher resilience was significantly associated with superior MHHS scores (High: 93.3±8.7, Normal: 84.7±13.6, Low: 75.7±17.1; H=8.29, p=0.016), with a significant difference between the high and low resilience groups (p=0.016). BRS score correlated strongly with 6-month MHHS on both Pearson (r=0.522, p<0.001) and Spearman (ρ=0.506, p<0.001) analysis. PROMIS Mental Health also differed significantly across tertiles (H = 7.437, p=0.024), driven by a significant difference between the high and normal resilience groups (p=0.007). PROMIS Physical Health also showed a significant continuous correlation with BRS (Pearson r=0.273, p=0.048; Spearman ρ=0.283, p=0.040). At 12 months (n=29; Low n=11, Normal n=9, High n=9; Group A: n=22, Group B: n=7), a significant group-level difference in MHHS was observed (High: 98.2±2.2, Normal: 86.9±15.6, Low: 79.6±18.3; H=7.02, p=0.030), with strong continuous correlations (Pearson r=0.517, p=0.004; Spearman ρ=0.490, p=0.007). There were also significant differences between high and low resiliency groups (p=0.021), and high and normal groups (p=0.040). ED visits occurred in 13 patients (20.0%), revision surgery in 3 (4.6%), and hospital readmissions in 5 (7.7%). ED and hospital readmissions rates did not differ significantly by resilience tertile at 6 months (p=0.973). Further longitudinal data collection will be required for analysis on reoperation rates. Conclusion Resilience is a significant predictor of hip-specific and mental health outcomes following HPS. These findings support resilience as a clinically actionable target for perioperative optimization. Incorporating resilience assessments into routine care may help identify patients at risk for worse outcomes and guide targeted interventions aimed at improving recovery. Additionally, future studies should investigate whether targeted perioperative interventions such as psychological coaching, mindfulness programs, or increased patient education can improve BRS scores and in turn drive better postoperative outcomes.
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Authors Peter Levin, Kira L. Smith, Andrew Qi, Robert Wetzel, Michael Jonathan Salata
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.174
URL
https://doi.org/10.1093/jhps/hnag043.174
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