EP264 Lack of Validated Patient Reported Outcome Tools Persists in Pediatric and Adolescent Hip Arthroscopy – A Systematic Review

Hip arthroscopy is increasingly used in hip pathologies in children and adolescents. However, the validity of adult-derived patient-reported outcome (PRO) tools in pediatric patients remains unclear. This study aims to identify commonly used PRO scores in this subgroup and evaluate their validity.

Two systematic searches of MEDLINE, Embase, and CENTRAL, from inception to March 31st, 2024 and August 22nd, 2024, respectively, followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The first search identified PRO instruments used in studies on hip arthroscopy on patients aged 19 and under. The second focused on clinimetric properties of these tools in pediatric hip arthroscopy. PRO utilization was stratified by pathology, trends over 5-year intervals from 2005 to 2024, and publication type. A descriptive analysis was planned for clinimetric studies.

Fifty-seven studies were included, identifying 10 hip-specific and 5 nonspecific PROs. The second search did not identify any clinimetric studies on these tools used in pediatric patients. The most commonly reported hip-specific PRO were the modified Hip Harris Score (mHHS) (n=48), the Hip Outcome Score – Sport Specific Subscale (HOS-SS) (n=25) and the Non-Arthritic Hip Score (n=20). Hip arthroscopy was used to treat over seven different conditions, with femoroacetabular impingement being the most common (n=41, 77%). Between 2005 and 2024, the variety of hip-specific PROs increased, with seven new introduced by 2019-2024. Additionally, this study found a relatively equal distribution of outcomes across presentation abstracts and manuscripts.

The key finding of this study is the ongoing lack of hip-specific PRO tools in the pediatric hip arthroscopy literature, with reliance on adult-derived instruments. The absence of clinimetric studies and heterogeneity in PRO use emphasises the need for standardized, pediatric-specific tools. Developing and validating such instruments should be prioritized to ensure accurate, age-appropriate outcome assessment and care.