Patient-Defined Outcomes in Arthrosis of the Hip: What Activities Do Patients Hope to Improve with Treatment?

BACKGROUND: Patient-reported outcome measures (PROMs) may not fully characterize the limitations patients experience nor describe patient expectations. Patient-defined outcomes (PDOs) enable patients to articulate their limitations and goals. This study aimed to determine PDOs in patients who have hip osteoarthritis (OA), the effect of patient demographics, and compare PDOs to PROMs in patients who have hip OA.

METHODS: This retrospective case-control study included all patients who had hip OA and presented to a tertiary hip center from March 9, 2023, to October 3, 2024. Patients who had Tonnis Grade 2 or 3 arthritis were included. Patients who have hip conditions such as osteonecrosis, Perthes, and previous hip surgery were excluded. Outcome measures included PDOs, Hip Disability and Osteoarthritis Outcome Score (HOOS) global, International Hip Outcome Tool (iHot 12), and Patient-Reported Outcome Measurement Information System Physical Function (PROMIS PF). Patients were classified by age as adults (20 to 60 years) or as senior adults (greater than 60 years). Outcome measures were analyzed using multiple linear regression models, two-sample t-tests, and Fisher's exact tests. A total of 237 patients met the inclusion criteria for this study. There were 91 adult patients and 146 senior adult patients.

RESULTS: Senior adults reported interest in improving low-intensity and low-range-of-motion (ROM) activities. Adults reported interest in high-intensity and high-ROM activities. Importance level did not change among age cohorts. Difficulty did not correlate with age. There were no differences (P > 0.05) between the adult and senior adult groups across all selected PROMs and PDO scores.

CONCLUSION: Patients in both groups report trouble with Activity of Daily Living (ADLs) and want to be able to walk without pain. However, some patients in both groups wanted to return to higher-intensity activities like sports, running, hiking, and dancing. The PDOs help align provider and patient expectations.