Radiological hip shape and patient- reported outcome measures in healed Perthes' disease



Ali, MS, Khattak, M, Metcalfe, D and Perry, DC ORCID: 0000-0001-8420-8252
(2023) Radiological hip shape and patient- reported outcome measures in healed Perthes' disease. BONE & JOINT JOURNAL, 105B (6). pp. 711-716.

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Abstract

<h4>Aims</h4>This study aimed to evaluate the relationship between hip shape and mid-term function in Perthes' disease. It also explored whether the modified three-group Stulberg classification can offer similar prognostic information to the five-group system.<h4>Methods</h4>A total of 136 individuals aged 12 years or older who had Perthes' disease in childhood completed the Patient-Reported Outcomes Measurement Information System (PROMIS) Mobility score (function), Nonarthritic Hip Score (NAHS) (function), EuroQol five-dimension five-level questionnaire (EQ-5D-5L) score (quality of life), and the numeric rating scale for pain (NRS). The Stulberg class of the participants' hip radiographs were evaluated by three fellowship-trained paediatric orthopaedic surgeons. Hip shape and Stulberg class were compared to PROM scores.<h4>Results</h4>A spherical hip was associated with the highest function and quality of life, and lowest pain. Conversely, aspherical hips exhibited the lowest functional scores and highest pain. The association between worsening Stulberg class (i.e. greater deviation from sphericity) and worse outcome persisted after adjustment for age and sex in relation to PROMIS (predicted mean difference -1.77 (95% confidence interval (CI) -2.70 to -0.83)), NAHS (-5.68 (95% CI -8.45 to -2.90)), and NRS (0.61 (95% CI 0.14 to 1.08)), but not EQ-5D-5L (-0.03 (95% CI -0.72 to 0.11)).<h4>Conclusion</h4>Patient-reported outcomes identify lower function, quality of life, and higher pain in aspherical hips. The magnitude of symptoms deteriorated with time. Hip sphericity (i.e. the modified three-group classification of spherical, oval, and aspherical) appeared to offer similar levels of detail to the five-group Stulberg classification.

Item Type: Article
Uncontrolled Keywords: Hip Joint, Humans, Treatment Outcome, Follow-Up Studies, Quality of Life, Child, Legg-Calve-Perthes Disease, Patient Reported Outcome Measures
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User: Symplectic Admin
Date Deposited: 06 Oct 2023 13:08
Last Modified: 06 Oct 2023 13:08
DOI: 10.1302/0301-620X.105B6.
Open Access URL: https://doi.org/10.1302/0301-620X.105B6.BJJ-2022-1...
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URI: https://livrepository.liverpool.ac.uk/id/eprint/3173495