Patient-Defined Outcomes in Adults with Hip Dysplasia: What Activities Do Patients Hope to Improve with Treatment?

Introduction: Patient-reported outcome measures have widely been used in the field of orthopaedics to determine treatment outcomes; however, they may not always align with the patient's goals for improvement following treatment. Therefore, we introduced the concept of patient-defined outcomes (PDOs): pretreatment goals or activities patients wish to improve following treatment, along with the patient-perceived difficulty and importance of these activities. This study aimed to evaluate PDOs in adults with hip dysplasia across 3 age groups while assessing patient variables for potential associations with choosing specific categories of activities.

Methods: We analyzed PDOs in 180 adults diagnosed with hip dysplasia, stratified into age groups: young adults (18-39 years), older adults (40-59 years), and senior adults (60 years or older). Patients listed at least 1 activity into the PDO questionnaire, followed by rating the difficulty and importance of the activity on a scale from zero to 10. PDOs were grouped into 6 thematic categories: sports, exercise, hobbies, activities of daily living (ADLs), work, and social engagement.

Results: ADLs were the most common PDO reported across all age groups, increasing from 47.2% of young adults to 68.2% of seniors, while exercise-related goals were the second most common reported PDO. Age and body mass index significantly positively related with choosing an ADL as a PDO (p = 0.017). Age (p = 0.041) and Pain Catastrophizing Score (p = 0.042) significantly negatively related, while University of California Activity Score (p = 0.020) showed a significant positive relationship, with reporting an exercise as a PDO. Almost all patients reported patient-perceived importance at the highest levels.

Conclusion: These findings underscore the impact hip dysplasia has on function, as most patients, regardless of age, expressed a desire to improve in basic ADLs. In addition, the importance levels of activities were consistently high across all age groups, highlighting the significance of aligning treatment goals with patient-centered outcomes.

Level of evidence: Level IV. See Instructions for Authors for a complete description of levels of evidence.